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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $12,022.64 Typical High $14,791.08 | Professional | None | $5,011.87 | $12,022.64 | $14,791.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,488.17 Median $16,218.10 Typical High $24,547.09 | Facility | None | $15,488.17 | $16,218.10 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
Select Health Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $16,595.87 | Facility | None | $16,595.87 | $16,595.87 | $16,595.87 |
Select Health Setting Professional Modifier None Typical Low $8,317.64 Median $15,135.61 Typical High $16,595.87 | Professional | None | $8,317.64 | $15,135.61 | $16,595.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $10,232.93 Median $13,182.57 Typical High $18,620.87 | Professional | None | $10,232.93 | $13,182.57 | $18,620.87 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None Typical Low $4,786.30 Median $6,165.95 Typical High $12,022.64 | Professional | None | $4,786.30 | $6,165.95 | $12,022.64 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $398.11 |
Where Utah sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$9,120
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.