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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | None | $177.83 | $177.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $537.03 | Professional | None | $263.03 | $426.58 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $575.44 Typical High $870.96 | Facility | None | $549.54 | $575.44 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | None | $416.87 | $416.87 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $588.84 Typical High $676.08 | Professional | None | $295.12 | $588.84 | $676.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $812.83 | Professional | None | $363.08 | $467.74 | $812.83 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Facility | None | $363.08 | $363.08 | $371.54 |
United Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $467.74 | Professional | None | $218.78 | $275.42 | $467.74 |
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 $89.13 Median $89.13 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $22.91 |
Where Utah sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 20th of 51
$417
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.