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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $645.65 | Professional | None | $602.56 | $602.56 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,819.70 | $2,344.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,801.89 | Facility | None | $2,398.83 | $2,511.89 | $3,801.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,454.71 Typical High $2,570.40 | Professional | None | $1,288.25 | $2,454.71 | $2,570.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,041.74 | $3,090.30 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,862.09 | Professional | None | $741.31 | $933.25 | $1,862.09 |
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 $302.00 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $302.00 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 53 · Discontinued | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $64.57 |
Where Utah sits
The same service costs 3.0 times more in Montana 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· 25th of 51
$1,175
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.