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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,548.82 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $4,466.84 | Professional | None | $2,187.76 | $3,548.13 | $4,466.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $4,786.30 Typical High $7,244.36 | Facility | None | $4,570.88 | $4,786.30 | $7,244.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,890.45 | Professional | None | $3,467.37 | $3,467.37 | $3,890.45 |
Select Health Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $2,454.71 Median $4,897.79 Typical High $5,495.41 | Professional | None | $2,454.71 | $4,897.79 | $5,495.41 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $3,019.95 Median $3,981.07 Typical High $6,606.93 | Professional | None | $3,019.95 | $3,981.07 | $6,606.93 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,905.46 | $2,398.83 | $3,890.45 |
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 $776.25 Median $776.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $776.25 | $776.25 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | 53 · Discontinued | $309.03 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $208.93 |
Where Utah sits
The same service costs 4.3 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· 21st of 51
$3,467
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.