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 $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $741.31 | Professional | None | $363.08 | $588.84 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $1,202.26 | Facility | None | $758.58 | $794.33 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $812.83 Typical High $1,023.29 | Professional | None | $407.38 | $812.83 | $1,023.29 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $977.24 | Professional | None | $501.19 | $660.69 | $977.24 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $645.65 | Professional | None | $316.23 | $398.11 | $645.65 |
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 $181.97 | Professional | 52 · Reduced service | $128.82 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $36.31 |
Where Utah sits
The same service costs 3.9 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· 27th of 51
$501
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.