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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $288.40 | Professional | None | $134.90 | $134.90 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $389.05 | Professional | None | $190.55 | $302.00 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $416.87 Typical High $630.96 | Facility | None | $398.11 | $416.87 | $630.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $426.58 Typical High $478.63 | Professional | None | $213.80 | $426.58 | $478.63 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $575.44 | Professional | None | $263.03 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
United Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $331.13 | Professional | None | $162.18 | $208.93 | $331.13 |
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 $67.61 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $67.61 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $26.92 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $17.38 |
Where Utah sits
The same service costs 2.6 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· 23rd of 51
$288
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.