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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $112.20 | Professional | None | $56.23 | $56.23 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $165.96 | Professional | None | $79.43 | $128.82 | $165.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $177.83 Typical High $269.15 | Facility | None | $169.82 | $177.83 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $181.97 Typical High $204.17 | Professional | None | $89.13 | $181.97 | $204.17 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $213.80 | Professional | None | $109.65 | $144.54 | $213.80 |
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 $69.18 Median $87.10 Typical High $141.25 | Professional | None | $69.18 | $87.10 | $141.25 |
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 $28.18 Median $28.18 Typical High $33.88 | Professional | 52 · Reduced service | $28.18 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | 53 · Discontinued | $11.48 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.76 |
Where Utah sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$123
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.