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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $151.36 | Professional | None | $83.18 | $83.18 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $275.42 | Professional | None | $131.83 | $213.80 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $281.84 Median $295.12 Typical High $446.68 | Facility | None | $281.84 | $295.12 | $446.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $302.00 | Professional | None | $151.36 | $281.84 | $302.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $331.13 | Professional | None | $186.21 | $239.88 | $331.13 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Facility | None | $147.91 | $147.91 | $151.36 |
United Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $234.42 | Professional | None | $102.33 | $128.82 | $234.42 |
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 $41.69 Median $41.69 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $20.89 | Professional | 53 · Discontinued | $16.98 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $10.47 |
Where Utah sits
The same service costs 2.3 times more in Hawaii than in New Jersey. 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
$186
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.