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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | None | $42.66 | $42.66 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $162.18 | Professional | None | $77.62 | $125.89 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $162.18 Median $173.78 Typical High $263.03 | Facility | None | $162.18 | $173.78 | $263.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $173.78 | Professional | None | $87.10 | $165.96 | $173.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $194.98 | Professional | None | $107.15 | $141.25 | $194.98 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $87.10 | Facility | None | $75.86 | $75.86 | $87.10 |
United Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $128.82 | Professional | None | $51.29 | $66.07 | $128.82 |
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 $21.38 Median $21.38 Typical High $27.54 | Professional | 52 · Reduced service | $21.38 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $10.96 | Professional | 53 · Discontinued | $8.51 | $8.51 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.50 |
Where Utah sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 18th of 51
$102
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.