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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $169.82 | Professional | None | $104.71 | $104.71 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $257.04 | Professional | None | $125.89 | $204.17 | $257.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $263.03 Median $275.42 Typical High $416.87 | Facility | None | $263.03 | $275.42 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $281.84 | Professional | None | $141.25 | $275.42 | $281.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $331.13 | Professional | None | $181.97 | $229.09 | $331.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $239.88 | Professional | None | $95.50 | $123.03 | $239.88 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where Utah sits
The same service costs 2.2 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· 45th of 51
$141
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.