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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $645.65 | Professional | None | $426.58 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $436.52 Typical High $549.54 | Professional | None | $60.26 | $436.52 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $575.44 Median $602.56 Typical High $1,202.26 | Facility | None | $575.44 | $602.56 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | None | $426.58 | $426.58 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $870.96 Typical High $933.25 | Professional | None | $309.03 | $870.96 | $933.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $870.96 | Professional | None | $436.52 | $616.60 | $870.96 |
United Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $562.34 | Professional | None | $269.15 | $478.63 | $562.34 |
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 $213.80 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
Where Utah sits
The same service costs 2.2 times more in Kansas 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
$457
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.