How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | None | $281.84 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $354.81 Typical High $407.38 | Facility | None | $316.23 | $354.81 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $346.74 | Professional | None | $194.98 | $269.15 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $676.08 | Facility | None | $389.05 | $524.81 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $288.40 | Professional | None | $165.96 | $288.40 | $288.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $123.03 Median $275.42 Typical High $398.11 | Professional | None | $123.03 | $275.42 | $398.11 |
United Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $141.25 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $32.36 | $32.36 |
Where Utah sits
Rates are fairly even across states for this service. 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· 13th of 51
$282
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.