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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $204.17 | Professional | None | $158.49 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $512.86 | Professional | None | $251.19 | $398.11 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $549.54 Typical High $831.76 | Facility | None | $524.81 | $549.54 | $831.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | None | $389.05 | $389.05 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $676.08 | Professional | None | $281.84 | $562.34 | $676.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $794.33 | Professional | None | $346.74 | $446.68 | $794.33 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Facility | None | $331.13 | $331.13 | $426.58 |
United Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $436.52 | Professional | None | $194.98 | $245.47 | $436.52 |
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 $79.43 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $79.43 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $20.42 |
Where Utah sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 19th of 51
$389
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.