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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,202.26 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,905.46 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,981.07 | Facility | None | $2,511.89 | $2,630.27 | $3,981.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $2,691.53 | Professional | None | $1,348.96 | $2,570.40 | $2,691.53 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,137.96 | $3,019.95 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,258.93 | Facility | None | $977.24 | $977.24 | $1,258.93 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,089.30 | Professional | None | $891.25 | $1,148.15 | $2,089.30 |
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 $165.96 | Professional | 53 · Discontinued | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $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 Hawaii than in Vermont. 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
$1,660
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.