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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | None | $97.72 | $97.72 | $123.03 |
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 $151.36 Median $239.88 Typical High $309.03 | Professional | None | $151.36 | $239.88 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $316.23 Median $331.13 Typical High $501.19 | Facility | None | $316.23 | $331.13 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | None | $234.42 | $234.42 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $338.84 | Professional | None | $169.82 | $338.84 | $338.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $407.38 | Professional | None | $208.93 | $269.15 | $407.38 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $263.03 | Professional | None | $117.49 | $151.36 | $263.03 |
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 $48.98 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $48.98 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $23.44 | Professional | 53 · Discontinued | $19.50 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $11.75 |
Where Utah sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 27th of 51
$191
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.