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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | None | $64.57 | $64.57 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $245.47 | Professional | None | $117.49 | $190.55 | $245.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $398.11 | Facility | None | $245.47 | $257.04 | $398.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $263.03 | Professional | None | $131.83 | $263.03 | $263.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $316.23 | Professional | None | $162.18 | $213.80 | $316.23 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $194.98 | Professional | None | $77.62 | $100.00 | $194.98 |
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 $32.36 Median $32.36 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $13.80 | Professional | 53 · Discontinued | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.23 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.76 |
Where Utah sits
The same service costs 2.5 times more in Montana than in Arizona. 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· 21st of 51
$145
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.