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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $61.66 | Professional | None | $48.98 | $48.98 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $186.21 | Professional | None | $91.20 | $147.91 | $186.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $302.00 | Facility | None | $190.55 | $199.53 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $204.17 | Professional | None | $102.33 | $186.21 | $204.17 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $229.09 | Professional | None | $125.89 | $165.96 | $229.09 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $147.91 | Professional | None | $58.88 | $75.86 | $147.91 |
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 $24.55 Median $24.55 Typical High $30.90 | Professional | 52 · Reduced service | $24.55 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $12.30 | Professional | 53 · Discontinued | $9.77 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.17 |
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· 24th of 51
$97.72
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.