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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $346.74 | Professional | None | $162.18 | $162.18 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $537.03 | Professional | None | $257.04 | $416.87 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $575.44 Typical High $870.96 | Facility | None | $549.54 | $575.44 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $588.84 | Professional | None | $288.40 | $562.34 | $588.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $676.08 | Professional | None | $354.81 | $467.74 | $676.08 |
United Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $457.09 | Professional | None | $194.98 | $251.19 | $457.09 |
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 $81.28 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $32.36 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $18.62 |
Where Utah sits
The same service costs 2.6 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· 30th of 51
$316
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.