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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,258.93 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,090.30 | Professional | None | $2,238.72 | $2,238.72 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,041.74 | $3,235.94 | $4,168.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,265.80 Median $4,466.84 Typical High $6,760.83 | Facility | None | $4,265.80 | $4,466.84 | $6,760.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $2,290.87 Median $4,365.16 Typical High $4,570.88 | Professional | None | $2,290.87 | $4,365.16 | $4,570.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $5,248.07 | Professional | None | $2,818.38 | $3,630.78 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,548.82 | $1,949.84 | $3,548.13 |
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 $630.96 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 53 · Discontinued | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $141.25 |
Where Utah sits
The same service costs 2.0 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· 24th of 51
$3,020
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.