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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | None | $97.72 | $97.72 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $288.40 | Professional | None | $134.90 | $218.78 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $288.40 Median $302.00 Typical High $457.09 | Facility | None | $288.40 | $302.00 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | None | $213.80 | $213.80 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $309.03 | Professional | None | $154.88 | $309.03 | $309.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $371.54 | Professional | None | $190.55 | $245.47 | $371.54 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $263.03 | Facility | None | $199.53 | $199.53 | $263.03 |
United Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $239.88 | Professional | None | $117.49 | $151.36 | $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 $48.98 Median $48.98 Typical High $61.66 | Professional | 52 · Reduced service | $48.98 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | 53 · Discontinued | $19.50 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $18.62 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $12.30 |
Where Utah sits
The same service costs 5.0 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· 26th of 51
$186
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.