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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | None | $56.23 | $56.23 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $218.78 | Professional | None | $107.15 | $169.82 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $234.42 Typical High $354.81 | Facility | None | $223.87 | $234.42 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $239.88 | Professional | None | $120.23 | $218.78 | $239.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $269.15 | Professional | None | $147.91 | $190.55 | $269.15 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Facility | None | $89.13 | $89.13 | $107.15 |
United Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $173.78 | Professional | None | $69.18 | $87.10 | $173.78 |
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 $28.18 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $7.24 |
Where Utah sits
The same service costs 3.0 times more in Montana 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· 29th of 51
$110
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.