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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $2,951.21 | Professional | None | $1,412.54 | $2,290.87 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $4,786.30 | Facility | None | $3,019.95 | $3,162.28 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,570.40 | Professional | None | $2,238.72 | $2,238.72 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $1,621.81 Median $3,235.94 Typical High $3,630.78 | Professional | None | $1,621.81 | $3,235.94 | $3,630.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $4,365.16 | Professional | None | $1,995.26 | $2,570.40 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,621.81 | $1,621.81 | $1,862.09 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,412.54 | $2,511.89 |
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 $457.09 Median $457.09 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $457.09 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $120.23 |
Where Utah sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 28th of 51
$1,862
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.