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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
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 $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Molina Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,412.54 | Professional | None | $676.08 | $1,096.48 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,290.87 | Facility | None | $1,412.54 | $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 $1,513.56 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 $1,445.44 Typical High $1,513.56 | Professional | None | $758.58 | $1,445.44 | $1,513.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,698.24 | Professional | None | $933.25 | $1,230.27 | $1,698.24 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $891.25 | Facility | None | $870.96 | $870.96 | $891.25 |
United Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,202.26 | Professional | None | $524.81 | $660.69 | $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 $213.80 Median $213.80 Typical High $295.12 | Professional | 52 · Reduced service | $213.80 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | 53 · Discontinued | $85.11 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $58.88 |
Where Utah sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 29th 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.