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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $117.49 | Professional | None | $93.33 | $93.33 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $269.15 | Professional | None | $128.82 | $208.93 | $269.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $436.52 | Facility | None | $275.42 | $288.40 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | None | $204.17 | $204.17 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $346.74 | Professional | None | $147.91 | $295.12 | $346.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $416.87 | Professional | None | $181.97 | $234.42 | $416.87 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Facility | None | $190.55 | $190.55 | $208.93 |
United Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $229.09 | Professional | None | $112.20 | $144.54 | $229.09 |
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 $46.77 Median $46.77 Typical High $58.88 | Professional | 52 · Reduced service | $46.77 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $18.62 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $11.75 |
Where Utah sits
The same service costs 3.4 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· 23rd of 51
$204
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.