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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $660.69 | Professional | None | $501.19 | $501.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | None | $707.95 | $707.95 | $954.99 |
Molina Setting Professional Modifier None Typical Low $912.01 Median $1,479.11 Typical High $1,905.46 | Professional | None | $912.01 | $1,479.11 | $1,905.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $3,090.30 | Facility | None | $1,949.84 | $2,041.74 | $3,090.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,949.84 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,949.84 | $2,089.30 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,659.59 | $2,290.87 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $1,023.29 | Facility | None | $173.78 | $173.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,513.56 | Professional | None | $602.56 | $776.25 | $1,513.56 |
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 $245.47 Median $245.47 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $66.07 |
Where Utah sits
The same service costs 3.2 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
$1,047
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.