How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $229.09 Median $3,162.28 Typical High $9,332.54 | Facility | None | $229.09 | $3,162.28 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $338.84 | Professional | None | $158.49 | $229.09 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $177.83 Typical High $181.97 | Facility | None | $165.96 | $177.83 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $331.13 Typical High $891.25 | Professional | None | $165.96 | $331.13 | $891.25 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $208.93 | Professional | None | $144.54 | $169.82 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $354.81 | Professional | None | $154.88 | $281.84 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $154.88 Median $331.13 Typical High $524.81 | Professional | None | $154.88 | $331.13 | $524.81 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $446.68 | Professional | None | $123.03 | $213.80 | $446.68 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $114.82 Typical High $169.82 | Professional | 52 · Reduced service | $95.50 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $67.61 | Professional | 53 · Discontinued | $38.90 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $257.04 | Professional | 54 · Surgery only | $144.54 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $51.29 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.91 Typical High $33.88 | Professional | 56 · Pre-op care only | $19.05 | $22.91 | $33.88 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,630.78 Median $4,570.88 Typical High $6,606.93 | Facility | 50 · Both sides | $3,630.78 | $4,570.88 | $6,606.93 |
Where Utah sits
The same service costs 3.2 times more in Oklahoma than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Utah· 48th of 51
$214
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.