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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $954.99 | Professional | None | $758.58 | $758.58 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,949.84 | $2,511.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $4,073.80 | Facility | None | $2,570.40 | $2,691.53 | $4,073.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $2,754.23 | Professional | None | $1,380.38 | $2,630.27 | $2,754.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,187.76 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,584.89 | $1,584.89 | $1,659.59 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,137.96 | Professional | None | $912.01 | $1,174.90 | $2,137.96 |
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 $380.19 Median $380.19 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $95.50 |
Where Utah sits
The same service costs 3.1 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· 25th of 51
$1,549
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.