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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $426.58 | Professional | None | $346.74 | $346.74 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $1,122.02 | Professional | None | $549.54 | $870.96 | $1,122.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,819.70 | Facility | None | $1,148.15 | $1,202.26 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | None | $851.14 | $851.14 | $912.01 |
Select Health 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 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,288.25 | Professional | None | $616.60 | $1,230.27 | $1,288.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,548.82 | Professional | None | $758.58 | $977.24 | $1,548.82 |
United Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $645.65 | Facility | None | $616.60 | $616.60 | $645.65 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $977.24 | Professional | None | $426.58 | $537.03 | $977.24 |
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 $173.78 Median $173.78 Typical High $208.93 | Professional | 52 · Reduced service | $173.78 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $42.66 |
Where Utah sits
The same service costs 2.3 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· 20th of 51
$851
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.