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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,949.84 | $1,949.84 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $3,630.78 Median $5,888.44 Typical High $7,585.78 | Professional | None | $3,630.78 | $5,888.44 | $7,585.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,762.47 Median $8,128.31 Typical High $12,302.69 | Facility | None | $7,762.47 | $8,128.31 | $12,302.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Select Health Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Select Health Setting Professional Modifier None Typical Low $4,168.69 Median $8,317.64 Typical High $8,317.64 | Professional | None | $4,168.69 | $8,317.64 | $8,317.64 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $5,128.61 Median $6,606.93 Typical High $10,000.00 | Professional | None | $5,128.61 | $6,606.93 | $10,000.00 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Facility | None | $4,073.80 | $4,073.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $6,025.60 | Professional | None | $2,398.83 | $3,019.95 | $6,025.60 |
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 $977.24 Median $977.24 Typical High $1,318.26 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $524.81 | Professional | 53 · Discontinued | $398.11 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $263.03 |
Where Utah sits
The same service costs 3.9 times more in Hawaii than in Washington, DC. 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· 21st of 51
$4,677
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.