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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | None | $776.25 | $776.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,380.38 | $2,238.72 | $2,884.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,951.21 Median $3,090.30 Typical High $4,677.35 | Facility | None | $2,951.21 | $3,090.30 | $4,677.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Select Health Setting Professional Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $3,162.28 | Professional | None | $1,584.89 | $3,019.95 | $3,162.28 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,511.89 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Facility | None | $1,412.54 | $1,412.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,344.23 | Professional | None | $954.99 | $1,202.26 | $2,344.23 |
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 $389.05 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $154.88 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $100.00 |
Where Utah sits
The same service costs 2.7 times more in Hawaii than in Maryland. 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
$1,778
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.