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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $354.81 | Professional | None | $281.84 | $281.84 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $870.96 | Professional | None | $416.87 | $676.08 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $870.96 Median $933.25 Typical High $1,412.54 | Facility | None | $870.96 | $933.25 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $933.25 | Professional | None | $467.74 | $891.25 | $933.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,071.52 | Professional | None | $575.44 | $758.58 | $1,071.52 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Facility | None | $549.54 | $549.54 | $660.69 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $741.31 | Professional | None | $338.84 | $436.52 | $741.31 |
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 $141.25 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $56.23 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $53.70 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $35.48 |
Where Utah sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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· 26th of 51
$562
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.