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 $100.00 Median $218.78 Typical High $4,570.88 | Facility | None | $100.00 | $218.78 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $218.78 | Professional | None | $100.00 | $199.53 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $741.31 | Professional | None | $112.20 | $229.09 | $741.31 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $776.25 | Professional | None | $524.81 | $630.96 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $851.14 | Professional | None | $100.00 | $251.19 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $758.58 | Professional | None | $97.72 | $141.25 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $109.65 Median $758.58 Typical High $1,412.54 | Professional | None | $109.65 | $758.58 | $1,412.54 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $13,803.84 Typical High $13,803.84 | Facility | None | $2,570.40 | $13,803.84 | $13,803.84 |
United Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $831.76 | Professional | None | $87.10 | $190.55 | $831.76 |
5 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 $50.12 Median $63.10 Typical High $109.65 | Professional | 52 · Reduced service | $50.12 | $63.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.12 Typical High $43.65 | Professional | 53 · Discontinued | $19.95 | $25.12 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $93.33 Typical High $162.18 | Professional | 54 · Surgery only | $75.86 | $93.33 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $32.36 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.59 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.00 | $12.59 | $21.88 |
Where Utah sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 5th of 51
$575
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.