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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $128.82 | Professional | None | $60.26 | $95.50 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $165.96 Median $173.78 Typical High $389.05 | Facility | None | $165.96 | $173.78 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | None | $123.03 | $123.03 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $331.13 Typical High $346.74 | Professional | None | $89.13 | $331.13 | $346.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $316.23 | Professional | None | $131.83 | $194.98 | $316.23 |
United Setting Professional Modifier None Typical Low $67.61 Median $186.21 Typical High $190.55 | Professional | None | $67.61 | $186.21 | $190.55 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.22 |
Where Utah sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 51st of 51
$162
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.