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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | None | $245.47 | $245.47 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $954.99 | Professional | None | $457.09 | $741.31 | $954.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,548.82 | Facility | None | $954.99 | $1,023.29 | $1,548.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $1,023.29 | Professional | None | $512.86 | $933.25 | $1,023.29 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,148.15 | Professional | None | $630.96 | $831.76 | $1,148.15 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
United Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $741.31 | Professional | None | $295.12 | $380.19 | $741.31 |
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 $123.03 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $123.03 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | 53 · Discontinued | $48.98 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $33.11 |
Where Utah sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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· 16th of 51
$661
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.