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 $147.91 Median $3,162.28 Typical High $6,025.60 | Facility | None | $147.91 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $190.55 | Professional | None | $134.90 | $147.91 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | None | $141.25 | $141.25 | $229.09 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $141.25 | Professional | None | $91.20 | $114.82 | $141.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $588.84 | Facility | None | $323.59 | $407.38 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $190.55 | Professional | None | $144.54 | $169.82 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $208.93 | Professional | None | $134.90 | $181.97 | $208.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $251.19 | Professional | None | $107.15 | $173.78 | $251.19 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $208.93 | Professional | None | $112.20 | $131.83 | $208.93 |
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 $67.61 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $67.61 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $112.20 | Professional | 54 · Surgery only | $100.00 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $20.42 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $13.49 | $14.79 | $14.79 |
Where Utah sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 40th of 51
$141
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.