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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $2,137.96 Median $3,388.44 Typical High $4,365.16 | Professional | None | $2,137.96 | $3,388.44 | $4,365.16 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $7,079.46 | Facility | None | $4,466.84 | $4,677.35 | $7,079.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,467.37 | Professional | None | $3,311.31 | $3,311.31 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $2,398.83 Median $4,786.30 Typical High $4,897.79 | Professional | None | $2,398.83 | $4,786.30 | $4,897.79 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $5,888.44 | Professional | None | $2,951.21 | $3,801.89 | $5,888.44 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,584.89 | $2,041.74 | $3,715.35 |
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 $660.69 Median $660.69 Typical High $776.25 | Professional | 52 · Reduced service | $660.69 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $158.49 |
Where Utah sits
The same service costs 2.1 times more in Montana than in South Carolina. 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
$3,311
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.