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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | None | $208.93 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $269.15 Typical High $309.03 | Facility | None | $234.42 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | None | $199.53 | $199.53 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $549.54 | Facility | None | $323.59 | $398.11 | $549.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | None | $165.96 | $213.80 | $213.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $302.00 | Professional | None | $186.21 | $223.87 | $302.00 |
United Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $104.71 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $23.99 |
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· 40th of 51
$204
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.