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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | None | $169.82 | $169.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $645.65 | Professional | None | $309.03 | $501.19 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $1,047.13 | Facility | None | $645.65 | $676.08 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $691.83 | Professional | None | $346.74 | $660.69 | $691.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $776.25 | Professional | None | $426.58 | $562.34 | $776.25 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $512.86 | Professional | None | $204.17 | $263.03 | $512.86 |
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 $85.11 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $21.38 |
Where Utah sits
The same service costs 4.5 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· 23rd of 51
$372
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.