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 $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,754.40 | Professional | None | $5,495.41 | $5,495.41 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Facility | None | $11,748.98 | $11,748.98 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $11,748.98 | Professional | None | $8,511.38 | $8,511.38 | $11,748.98 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $15,135.61 Typical High $19,054.61 | Professional | None | $5,011.87 | $15,135.61 | $19,054.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,952.62 Median $20,892.96 Typical High $31,622.78 | Facility | None | $19,952.62 | $20,892.96 | $31,622.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $14,791.08 | Professional | None | $14,791.08 | $14,791.08 | $14,791.08 |
Select Health Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Select Health Setting Professional Modifier None Typical Low $10,715.19 Median $19,054.61 Typical High $21,379.62 | Professional | None | $10,715.19 | $19,054.61 | $21,379.62 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $13,182.57 Median $16,982.44 Typical High $23,442.29 | Professional | None | $13,182.57 | $16,982.44 | $23,442.29 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,912.51 | Facility | None | $7,585.78 | $7,585.78 | $8,912.51 |
United Setting Professional Modifier None Typical Low $6,606.93 Median $8,511.38 Typical High $16,595.87 | Professional | None | $6,606.93 | $8,511.38 | $16,595.87 |
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 $2,754.23 Median $2,754.23 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,754.23 | $2,754.23 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,096.48 Typical High $1,148.15 | Professional | 53 · Discontinued | $1,096.48 | $1,096.48 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $812.83 Typical High $870.96 | Professional | 55 · Aftercare only | $812.83 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | 56 · Pre-op care only | $549.54 | $549.54 | $575.44 |
Where Utah sits
The same service costs 2.6 times more in Montana than in New Jersey. 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· 23rd of 51
$11,749
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.