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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | None | $208.93 | $208.93 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $616.60 | Professional | None | $302.00 | $489.78 | $616.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $660.69 Typical High $1,000.00 | Facility | None | $630.96 | $660.69 | $1,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | None | $478.63 | $478.63 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $676.08 Typical High $794.33 | Professional | None | $338.84 | $676.08 | $794.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $933.25 | Professional | None | $416.87 | $549.54 | $933.25 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Facility | None | $436.52 | $436.52 | $575.44 |
United Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $537.03 | Professional | None | $257.04 | $323.59 | $537.03 |
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 $104.71 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $26.92 |
Where Utah sits
The same service costs 4.3 times more in Hawaii 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· 23rd of 51
$407
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.