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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $114.82 | Professional | None | $83.18 | $83.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $251.19 | Professional | None | $120.23 | $194.98 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $257.04 Median $269.15 Typical High $407.38 | Facility | None | $257.04 | $269.15 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $288.40 | Professional | None | $138.04 | $275.42 | $288.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $346.74 | Professional | None | $169.82 | $218.78 | $346.74 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
United Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $213.80 | Professional | None | $100.00 | $128.82 | $213.80 |
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 $41.69 Median $41.69 Typical High $57.54 | Professional | 52 · Reduced service | $41.69 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $22.91 | Professional | 53 · Discontinued | $16.60 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $16.98 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $11.48 |
Where Utah sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 29th of 51
$158
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.