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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $269.15 | Professional | None | $128.82 | $208.93 | $269.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $436.52 | Facility | None | $275.42 | $288.40 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | None | $204.17 | $204.17 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $331.13 | Professional | None | $144.54 | $295.12 | $331.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $398.11 | Professional | None | $177.83 | $234.42 | $398.11 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Facility | None | $181.97 | $181.97 | $229.09 |
United Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $229.09 | Professional | None | $107.15 | $138.04 | $229.09 |
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 $43.65 Median $43.65 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $18.62 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $12.30 |
Where Utah sits
The same service costs 4.7 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· 27th of 51
$170
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.