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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $794.33 | Professional | None | $407.38 | $407.38 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
Molina Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,174.90 | Professional | None | $575.44 | $933.25 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,905.46 | Facility | None | $1,202.26 | $1,258.93 | $1,905.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | None | $912.01 | $912.01 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $1,288.25 Typical High $1,479.11 | Professional | None | $645.65 | $1,288.25 | $1,479.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,778.28 | Professional | None | $776.25 | $1,023.29 | $1,778.28 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $977.24 | Professional | None | $489.78 | $630.96 | $977.24 |
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 $204.17 Median $204.17 Typical High $275.42 | Professional | 52 · Reduced service | $204.17 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $83.18 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $54.95 |
Where Utah sits
The same service costs 3.2 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· 26th of 51
$832
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.