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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,162.28 | Professional | None | $3,019.95 | $3,019.95 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $7,943.28 Typical High $10,000.00 | Professional | None | $5,011.87 | $7,943.28 | $10,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,471.29 Median $10,964.78 Typical High $16,595.87 | Facility | None | $10,471.29 | $10,964.78 | $16,595.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Select Health Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
Select Health Setting Professional Modifier None Typical Low $5,623.41 Median $10,964.78 Typical High $11,220.18 | Professional | None | $5,623.41 | $10,964.78 | $11,220.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $6,918.31 Median $8,912.51 Typical High $13,182.57 | Professional | None | $6,918.31 | $8,912.51 | $13,182.57 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Facility | None | $4,265.80 | $4,265.80 | $4,786.30 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $4,677.35 Typical High $8,709.64 | Professional | None | $3,715.35 | $4,677.35 | $8,709.64 |
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 $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 53 · Discontinued | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $316.23 |
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· 21st of 51
$7,413
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.