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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | None | $676.08 | $676.08 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,659.59 | $2,137.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $3,467.37 | Facility | None | $2,187.76 | $2,290.87 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $2,754.23 | Professional | None | $1,174.90 | $2,344.23 | $2,754.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,862.09 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Facility | None | $1,122.02 | $1,122.02 | $1,258.93 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,819.70 | Professional | None | $812.83 | $1,047.13 | $1,819.70 |
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 $338.84 Median $338.84 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 53 · Discontinued | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $85.11 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $85.11 |
Where Utah sits
The same service costs 2.9 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· 27th of 51
$1,318
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.