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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | None | $181.97 | $181.97 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $602.56 | Professional | None | $288.40 | $467.74 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $977.24 | Facility | None | $616.60 | $645.65 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $537.03 | Professional | None | $457.09 | $457.09 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $758.58 | Professional | None | $331.13 | $660.69 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $912.01 | Professional | None | $407.38 | $524.81 | $912.01 |
United Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $371.54 | Facility | None | $269.15 | $269.15 | $371.54 |
United Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $512.86 | Professional | None | $218.78 | $281.84 | $512.86 |
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 $89.13 Median $89.13 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $23.44 |
Where Utah sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 23rd of 51
$372
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.