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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | None | $660.69 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,659.59 | $2,137.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $3,467.37 | Facility | None | $2,137.96 | $2,290.87 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,621.81 | $1,621.81 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $2,454.71 | Professional | None | $1,148.15 | $2,290.87 | $2,454.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,862.09 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Facility | None | $1,348.96 | $1,348.96 | $1,380.38 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,819.70 | Professional | None | $812.83 | $1,023.29 | $1,819.70 |
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 $331.13 Median $331.13 Typical High $446.68 | Professional | 52 · Reduced service | $331.13 | $331.13 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $134.90 | $177.83 |
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 $66.07 Median $66.07 Typical High $89.13 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $89.13 |
Where Utah sits
The same service costs 3.4 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· 25th of 51
$1,349
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.