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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | None | $457.09 | $457.09 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Molina Setting Professional Modifier None Typical Low $724.44 Median $1,174.90 Typical High $1,513.56 | Professional | None | $724.44 | $1,174.90 | $1,513.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,454.71 | Facility | None | $1,548.82 | $1,621.81 | $2,454.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,584.89 Typical High $1,659.59 | Professional | None | $812.83 | $1,584.89 | $1,659.59 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,318.26 | $1,905.46 |
United Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,288.25 | Professional | None | $549.54 | $707.95 | $1,288.25 |
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 $229.09 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $50.12 |
Where Utah sits
The same service costs 2.6 times more in Montana 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· 34th of 51
$933
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.