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 $251.19 Median $2,951.21 Typical High $4,570.88 | Facility | None | $251.19 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $549.54 | Professional | None | $186.21 | $338.84 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $316.23 | Professional | None | $218.78 | $257.04 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Facility | None | $616.60 | $812.83 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $467.74 | Professional | None | $173.78 | $302.00 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $616.60 | Professional | None | $239.88 | $426.58 | $616.60 |
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 $194.98 Median $380.19 Typical High $794.33 | Professional | None | $194.98 | $380.19 | $794.33 |
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 $93.33 Median $125.89 Typical High $269.15 | Professional | 52 · Reduced service | $93.33 | $125.89 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $109.65 | Professional | 53 · Discontinued | $38.02 | $50.12 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $190.55 Typical High $407.38 | Professional | 54 · Surgery only | $141.25 | $190.55 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $38.02 Typical High $81.28 | Professional | 55 · Aftercare only | $28.18 | $38.02 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $25.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $18.62 | $25.12 | $54.95 |
Where Utah sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 51st of 51
$288
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.