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 $16.60 Median $3,162.28 Typical High $6,025.60 | Facility | None | $16.60 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $16.60 Typical High $16.60 | Professional | None | $11.75 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $40.74 Typical High $60.26 | Professional | None | $10.00 | $40.74 | $60.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $19.95 | Professional | None | $12.59 | $14.79 | $19.95 |
Select Health Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Select Health Setting Professional Modifier None Typical Low $10.47 Median $13.80 Typical High $34.67 | Professional | None | $10.47 | $13.80 | $34.67 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $11.75 Median $19.95 Typical High $28.18 | Professional | None | $11.75 | $19.95 | $28.18 |
United Setting Professional Modifier None Typical Low $12.02 Median $14.45 Typical High $23.44 | Professional | None | $12.02 | $14.45 | $23.44 |
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 $5.89 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $5.89 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $2.34 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $12.30 Typical High $12.30 | Professional | 54 · Surgery only | $8.71 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $1.74 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.17 | $1.66 | $1.66 |
Where Utah sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 27th of 51
$14.79
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.