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 $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $812.83 | Professional | None | $741.31 | $741.31 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,445.44 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,778.28 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $3,715.35 | Facility | None | $2,290.87 | $2,454.71 | $3,715.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,737.80 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,230.27 | $2,454.71 | $2,884.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,995.26 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Facility | None | $1,096.48 | $1,096.48 | $1,258.93 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,949.84 | Professional | None | $912.01 | $1,148.15 | $1,949.84 |
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 $371.54 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $81.28 |
Where Utah sits
The same service costs 2.4 times more in Minnesota than in Washington, DC. 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· 23rd of 51
$1,738
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.