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 $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $14,125.38 | Professional | None | $12,589.25 | $12,589.25 | $14,125.38 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $31,622.78 Typical High $38,904.51 | Professional | None | $5,011.87 | $31,622.78 | $38,904.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $40,738.03 Median $42,657.95 Typical High $64,565.42 | Facility | None | $40,738.03 | $42,657.95 | $64,565.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $30,902.95 Median $30,902.95 Typical High $31,622.78 | Professional | None | $30,902.95 | $30,902.95 | $31,622.78 |
Select Health Setting Facility Modifier None Typical Low $43,651.58 Median $43,651.58 Typical High $43,651.58 | Facility | None | $43,651.58 | $43,651.58 | $43,651.58 |
Select Health Setting Professional Modifier None Typical Low $21,877.62 Median $43,651.58 Typical High $44,668.36 | Professional | None | $21,877.62 | $43,651.58 | $44,668.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $26,915.35 Median $34,673.69 Typical High $53,703.18 | Professional | None | $26,915.35 | $34,673.69 | $53,703.18 |
United Setting Professional Modifier None Typical Low $15,488.17 Median $19,498.45 Typical High $34,673.69 | Professional | None | $15,488.17 | $19,498.45 | $34,673.69 |
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 $6,309.57 Median $6,309.57 Typical High $7,079.46 | Professional | 52 · Reduced service | $6,309.57 | $6,309.57 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,511.89 Median $2,511.89 Typical High $2,818.38 | Professional | 53 · Discontinued | $2,511.89 | $2,511.89 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,905.46 Median $1,905.46 Typical High $2,089.30 | Professional | 55 · Aftercare only | $1,905.46 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $1,258.93 | $1,258.93 | $1,412.54 |
Where Utah sits
The same service costs 2.1 times more in Hawaii 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· 19th of 51
$30,200
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.