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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $100.00 | Professional | None | $48.98 | $48.98 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $141.25 | Professional | None | $67.61 | $109.65 | $141.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $229.09 | Facility | None | $144.54 | $151.36 | $229.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | None | $107.15 | $107.15 | $114.82 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $162.18 | Professional | None | $77.62 | $154.88 | $162.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $194.98 | Professional | None | $95.50 | $123.03 | $194.98 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $120.23 | Professional | None | $58.88 | $75.86 | $120.23 |
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 $24.55 Median $24.55 Typical High $31.62 | Professional | 52 · Reduced service | $24.55 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $12.88 | Professional | 53 · Discontinued | $9.77 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $9.55 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.46 |
Where Utah sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 22nd of 51
$107
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.