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 $512.86 Median $3,162.28 Typical High $6,025.60 | Facility | None | $512.86 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $512.86 | Professional | None | $389.05 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $371.54 | Professional | None | $269.15 | $309.03 | $371.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | None | $354.81 | $389.05 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $512.86 | Professional | None | $380.19 | $416.87 | $512.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $977.24 | Professional | None | $389.05 | $588.84 | $977.24 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $575.44 | Professional | None | $331.13 | $389.05 | $575.44 |
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 $194.98 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $295.12 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $51.29 | $51.29 |
Where Utah sits
The same service costs 4.5 times more in Alaska than in New York. 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
$355
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.