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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | None | $478.63 | $478.63 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,548.82 | Professional | None | $741.31 | $1,202.26 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,511.89 | Facility | None | $1,548.82 | $1,659.59 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,174.90 | $1,202.26 |
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 $831.76 Median $1,659.59 Typical High $1,737.80 | Professional | None | $831.76 | $1,659.59 | $1,737.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,348.96 | $2,089.30 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,318.26 | Professional | None | $575.44 | $741.31 | $1,318.26 |
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 $239.88 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $54.95 |
Where Utah sits
The same service costs 2.1 times more in Wisconsin than in Florida. 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· 19th of 51
$1,175
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.