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 $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $4,677.35 Median $7,585.78 Typical High $9,549.93 | Professional | None | $4,677.35 | $7,585.78 | $9,549.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Select Health Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,471.29 | Facility | None | $10,471.29 | $10,471.29 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $5,248.07 Median $10,471.29 Typical High $10,471.29 | Professional | None | $5,248.07 | $10,471.29 | $10,471.29 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $6,760.83 Median $8,511.38 Typical High $12,589.25 | Professional | None | $6,760.83 | $8,511.38 | $12,589.25 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $4,570.88 Typical High $8,912.51 | Professional | None | $3,548.13 | $4,570.88 | $8,912.51 |
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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $776.25 | $776.25 | $776.25 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $389.05 |
Where Utah sits
The same service costs 2.6 times more in Montana than in New York. 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· 32nd of 51
$5,623
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.