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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | None | $446.68 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,288.25 | Professional | None | $630.96 | $1,000.00 | $1,288.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $2,089.30 | Facility | None | $1,318.26 | $1,380.38 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $1,412.54 Typical High $1,412.54 | Professional | None | $707.95 | $1,412.54 | $1,412.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,698.24 | Professional | None | $870.96 | $1,122.02 | $1,698.24 |
United Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Facility | None | $912.01 | $912.01 | $1,000.00 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,096.48 | Professional | None | $537.03 | $691.83 | $1,096.48 |
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 $218.78 Median $218.78 Typical High $295.12 | Professional | 52 · Reduced service | $218.78 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $58.88 |
Where Utah sits
The same service costs 3.1 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· 25th of 51
$977
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.