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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $281.84 Median $281.84 Typical High $380.19 | Professional | None | $281.84 | $281.84 | $380.19 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $181.97 | Professional | None | $83.18 | $134.90 | $181.97 |
Regence BlueShield Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $524.81 | Facility | None | $239.88 | $245.47 | $524.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | None | $177.83 | $177.83 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $436.52 Typical High $512.86 | Professional | None | $125.89 | $436.52 | $512.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $389.05 | Professional | None | $190.55 | $263.03 | $389.05 |
United Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $263.03 | Professional | None | $95.50 | $257.04 | $263.03 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
Where Utah sits
The same service costs 3.0 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
$224
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.