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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | None | $478.63 | $478.63 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,380.38 | Professional | None | $676.08 | $1,071.52 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $2,238.72 | Facility | None | $1,412.54 | $1,479.11 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | None | $1,071.52 | $1,071.52 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $1,584.89 | Professional | None | $758.58 | $1,513.56 | $1,584.89 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $933.25 | $1,202.26 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Facility | None | $1,000.00 | $1,000.00 | $1,258.93 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,202.26 | Professional | None | $575.44 | $741.31 | $1,202.26 |
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 $302.00 | Professional | 52 · Reduced service | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $60.26 |
Where Utah sits
The same service costs 3.9 times more in Hawaii than in West Virginia. 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· 23rd of 51
$1,072
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.