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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | None | $199.53 | $199.53 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Facility | None | $524.81 | $524.81 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $588.84 | Professional | None | $281.84 | $457.09 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $588.84 Median $630.96 Typical High $954.99 | Facility | None | $588.84 | $630.96 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $794.33 | Professional | None | $316.23 | $630.96 | $794.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $758.58 | Professional | None | $389.05 | $512.86 | $758.58 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
United Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $501.19 | Professional | None | $245.47 | $309.03 | $501.19 |
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 $100.00 Median $100.00 Typical High $134.90 | Professional | 52 · Reduced service | $100.00 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $39.81 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $27.54 |
Where Utah sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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
$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.