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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,344.23 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $4,897.79 | Facility | None | $3,090.30 | $3,235.94 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $3,235.94 Typical High $3,311.31 | Professional | None | $1,659.59 | $3,235.94 | $3,311.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,630.27 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,698.24 | Facility | None | $1,479.11 | $1,479.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,454.71 | Professional | None | $977.24 | $1,230.27 | $2,454.71 |
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 $398.11 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $95.50 |
Where Utah sits
The same service costs 3.0 times more in Iowa 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
$1,660
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.