How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | None | $489.78 | $489.78 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | None | $691.83 | $691.83 | $933.25 |
Molina Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,584.89 | Professional | None | $776.25 | $1,258.93 | $1,584.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,570.40 | Facility | None | $1,621.81 | $1,698.24 | $2,570.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,698.24 Typical High $1,737.80 | Professional | None | $870.96 | $1,698.24 | $1,737.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,380.38 | $1,995.26 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,380.38 | Professional | None | $588.84 | $758.58 | $1,380.38 |
4 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 $239.88 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $56.23 |
Where Utah sits
The same service costs 2.6 times more in Hawaii 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· 31st of 51
$933
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.