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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $93.33 | Professional | None | $72.44 | $72.44 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $239.88 | Professional | None | $117.49 | $190.55 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $389.05 | Facility | None | $245.47 | $257.04 | $389.05 |
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 $251.19 Typical High $263.03 | Professional | None | $131.83 | $251.19 | $263.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $295.12 | Professional | None | $162.18 | $208.93 | $295.12 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $389.05 | Facility | None | $151.36 | $151.36 | $389.05 |
United Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $208.93 | Professional | None | $89.13 | $112.20 | $208.93 |
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 $36.31 Median $36.31 Typical High $45.71 | Professional | 52 · Reduced service | $36.31 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $18.62 | Professional | 53 · Discontinued | $14.45 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $13.80 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $9.33 |
Where Utah sits
The same service costs 8.1 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· 24th of 51
$141
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.