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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | None | $436.52 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Molina Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,412.54 | Professional | None | $691.83 | $1,096.48 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $2,290.87 | Facility | None | $1,445.44 | $1,513.56 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Select Health 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 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $1,548.82 | Professional | None | $776.25 | $1,479.11 | $1,548.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,698.24 | Professional | None | $954.99 | $1,230.27 | $1,698.24 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Facility | None | $630.96 | $630.96 | $776.25 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,202.26 | Professional | None | $524.81 | $676.08 | $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 $218.78 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $52.48 |
Where Utah sits
The same service costs 3.0 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
$851
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.