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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | None | $263.03 | $263.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
Molina Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $776.25 | Professional | None | $371.54 | $602.56 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $794.33 Median $831.76 Typical High $1,258.93 | Facility | None | $794.33 | $831.76 | $1,258.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | None | $588.84 | $588.84 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $851.14 Typical High $1,122.02 | Professional | None | $416.87 | $851.14 | $1,122.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,202.26 | Professional | None | $512.86 | $676.08 | $1,202.26 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Facility | None | $398.11 | $398.11 | $501.19 |
United Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $660.69 | Professional | None | $323.59 | $407.38 | $660.69 |
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 $131.83 Median $131.83 Typical High $162.18 | Professional | 52 · Reduced service | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $53.70 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $32.36 |
Where Utah sits
The same service costs 2.4 times more in Hawaii 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· 22nd of 51
$589
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.