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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $295.12 | Professional | None | $141.25 | $141.25 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $457.09 | Professional | None | $218.78 | $354.81 | $457.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $489.78 Typical High $741.31 | Facility | None | $467.74 | $489.78 | $741.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | None | $346.74 | $346.74 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $501.19 Typical High $537.03 | Professional | None | $251.19 | $501.19 | $537.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $645.65 | Professional | None | $309.03 | $398.11 | $645.65 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $389.05 | Facility | None | $295.12 | $295.12 | $389.05 |
United Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $389.05 | Professional | None | $173.78 | $218.78 | $389.05 |
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 $70.79 Median $70.79 Typical High $100.00 | Professional | 52 · Reduced service | $70.79 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | 53 · Discontinued | $28.18 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $19.95 |
Where Utah sits
The same service costs 3.8 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· 24th of 51
$324
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.