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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | None | $676.08 | $676.08 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,737.80 | $2,187.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $3,548.13 | Facility | None | $2,238.72 | $2,344.23 | $3,548.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $2,398.83 | Professional | None | $1,202.26 | $2,290.87 | $2,398.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,949.84 | $2,691.53 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,380.38 | Facility | None | $776.25 | $776.25 | $1,380.38 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,905.46 | Professional | None | $812.83 | $1,047.13 | $1,905.46 |
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 $338.84 Median $338.84 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $91.20 |
Where Utah sits
The same service costs 2.7 times more in Hawaii than in Pennsylvania. 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· 22nd of 51
$1,585
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.