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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,202.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,187.76 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $4,570.88 | Professional | None | $2,187.76 | $3,548.13 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $4,897.79 Typical High $7,413.10 | Facility | None | $4,570.88 | $4,897.79 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $2,454.71 Median $4,466.84 Typical High $4,897.79 | Professional | None | $2,454.71 | $4,466.84 | $4,897.79 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $3,019.95 Median $3,981.07 Typical High $5,495.41 | Professional | None | $3,019.95 | $3,981.07 | $5,495.41 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Facility | None | $2,041.74 | $2,041.74 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,630.78 | Professional | None | $1,445.44 | $1,862.09 | $3,630.78 |
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 $602.56 Median $602.56 Typical High $660.69 | Professional | 52 · Reduced service | $602.56 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $131.83 |
Where Utah sits
The same service costs 2.5 times more in Montana 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· 20th of 51
$2,951
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.