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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $478.63 | Professional | None | $257.04 | $257.04 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $616.60 Typical High $794.33 | Professional | None | $380.19 | $616.60 | $794.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $794.33 Median $851.14 Typical High $1,288.25 | Facility | None | $794.33 | $851.14 | $1,288.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $851.14 Typical High $851.14 | Professional | None | $426.58 | $851.14 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,023.29 | Professional | None | $524.81 | $691.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $676.08 | Professional | None | $316.23 | $398.11 | $676.08 |
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 $128.82 Median $128.82 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $44.67 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $29.51 |
Where Utah sits
The same service costs 2.4 times more in Iowa 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· 26th of 51
$550
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.