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 $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | None | $891.25 | $891.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,258.93 | $2,041.74 | $2,630.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $4,265.80 | Facility | None | $2,630.27 | $2,818.38 | $4,265.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $3,388.44 | Professional | None | $1,412.54 | $2,818.38 | $3,388.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,290.87 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,621.81 | Facility | None | $1,445.44 | $1,445.44 | $1,621.81 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,380.38 | $2,238.72 |
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 $446.68 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $104.71 |
Where Utah sits
The same service costs 2.7 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· 28th of 51
$1,738
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.