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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $331.13 | Professional | None | $234.42 | $234.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $676.08 | Professional | None | $323.59 | $524.81 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $724.44 Typical High $1,096.48 | Facility | None | $691.83 | $724.44 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | None | $512.86 | $512.86 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $741.31 Typical High $870.96 | Professional | None | $371.54 | $741.31 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,047.13 | Professional | None | $457.09 | $588.84 | $1,047.13 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $630.96 | Facility | None | $478.63 | $478.63 | $630.96 |
United Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $575.44 | Professional | None | $281.84 | $363.08 | $575.44 |
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 $114.82 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $114.82 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $31.62 |
Where Utah sits
The same service costs 4.6 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· 32nd of 51
$447
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.