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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $389.05 | Professional | None | $194.98 | $194.98 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $645.65 | Professional | None | $309.03 | $501.19 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $1,047.13 | Facility | None | $645.65 | $691.83 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $676.08 Typical High $691.83 | Professional | None | $346.74 | $676.08 | $691.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $812.83 | Professional | None | $426.58 | $562.34 | $812.83 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $549.54 | Professional | None | $234.42 | $302.00 | $549.54 |
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 $97.72 Median $97.72 Typical High $112.20 | Professional | 52 · Reduced service | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $22.39 |
Where Utah sits
The same service costs 2.2 times more in Montana 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· 24th of 51
$417
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.