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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $125.89 | Professional | None | $57.54 | $57.54 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $125.89 | Facility | None | $112.20 | $112.20 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $186.21 | Professional | None | $91.20 | $147.91 | $186.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $302.00 | Facility | None | $190.55 | $199.53 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $204.17 | Professional | None | $102.33 | $199.53 | $204.17 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $239.88 | Professional | None | $125.89 | $162.18 | $239.88 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $162.18 | Professional | None | $70.79 | $89.13 | $162.18 |
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 $28.84 Median $28.84 Typical High $33.11 | Professional | 52 · Reduced service | $28.84 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | 53 · Discontinued | $11.48 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $10.00 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.61 |
Where Utah sits
The same service costs 2.3 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· 31st of 51
$112
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.