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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $588.84 | Professional | None | $281.84 | $457.09 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $630.96 Typical High $954.99 | Facility | None | $602.56 | $630.96 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | None | $446.68 | $446.68 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $758.58 | Professional | None | $323.59 | $645.65 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $912.01 | Professional | None | $398.11 | $512.86 | $912.01 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Facility | None | $389.05 | $389.05 | $467.74 |
United Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $501.19 | Professional | None | $229.09 | $288.40 | $501.19 |
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 $93.33 Median $93.33 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $35.48 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $23.99 |
Where Utah sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 26th of 51
$380
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.