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 $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,165.95 | Professional | None | $5,623.41 | $5,623.41 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $15,488.17 Typical High $19,498.45 | Professional | None | $5,011.87 | $15,488.17 | $19,498.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,952.62 Median $21,379.62 Typical High $32,359.37 | Facility | None | $19,952.62 | $21,379.62 | $32,359.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | None | $15,135.61 | $15,135.61 | $15,135.61 |
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 $19,498.45 Typical High $21,379.62 | Professional | None | $10,715.19 | $19,498.45 | $21,379.62 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $13,182.57 Median $17,378.01 Typical High $23,988.33 | Professional | None | $13,182.57 | $17,378.01 | $23,988.33 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Facility | None | $7,943.28 | $7,943.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $6,760.83 Median $8,709.64 Typical High $16,982.44 | Professional | None | $6,760.83 | $8,709.64 | $16,982.44 |
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 $2,818.38 Median $2,818.38 Typical High $3,090.30 | Professional | 52 · Reduced service | $2,818.38 | $2,818.38 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | 53 · Discontinued | $1,122.02 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | 55 · Aftercare only | $851.14 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | 56 · Pre-op care only | $562.34 | $562.34 | $616.60 |
Where Utah sits
The same service costs 2.5 times more in Montana than in Florida. 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· 25th of 51
$12,589
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.