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 $125.89 | Professional | None | $97.72 | $97.72 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $281.84 | Professional | None | $138.04 | $223.87 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $288.40 Median $302.00 Typical High $457.09 | Facility | None | $288.40 | $302.00 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | None | $218.78 | $218.78 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $389.05 | Professional | None | $154.88 | $309.03 | $389.05 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $446.68 | Professional | None | $190.55 | $251.19 | $446.68 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
United Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $245.47 | Professional | None | $117.49 | $151.36 | $245.47 |
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 $63.10 | Professional | 52 · Reduced service | $48.98 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $25.12 | Professional | 53 · Discontinued | $19.50 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $12.59 |
Where Utah sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 19th of 51
$219
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.