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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $109.65 | Professional | None | $58.88 | $58.88 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $169.82 | Professional | None | $83.18 | $134.90 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $173.78 Median $181.97 Typical High $281.84 | Facility | None | $173.78 | $181.97 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | None | $131.83 | $131.83 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $223.87 | Professional | None | $93.33 | $186.21 | $223.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $269.15 | Professional | None | $114.82 | $151.36 | $269.15 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $147.91 | Professional | None | $72.44 | $91.20 | $147.91 |
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 $29.51 Median $29.51 Typical High $33.88 | Professional | 52 · Reduced service | $29.51 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $13.49 | Professional | 53 · Discontinued | $11.75 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $10.23 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.76 |
Where Utah sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 21st of 51
$126
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.