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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | None | $724.44 | $724.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,288.25 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,862.09 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,890.45 | Facility | None | $2,454.71 | $2,570.40 | $3,890.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $2,630.27 | Professional | None | $1,318.26 | $2,570.40 | $2,630.27 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,089.30 | $3,019.95 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Facility | None | $977.24 | $977.24 | $1,148.15 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,041.74 | Professional | None | $891.25 | $1,122.02 | $2,041.74 |
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 $363.08 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $74.13 |
Where Utah sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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
$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.