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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | None | $173.78 | $173.78 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $549.54 | Professional | None | $269.15 | $426.58 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $891.25 | Facility | None | $562.34 | $588.84 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $436.52 | Professional | None | $416.87 | $416.87 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $616.60 | Professional | None | $302.00 | $602.56 | $616.60 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $741.31 | Professional | None | $371.54 | $478.63 | $741.31 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $467.74 | Professional | None | $208.93 | $269.15 | $467.74 |
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 $87.10 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | 53 · Discontinued | $34.67 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $21.38 |
Where Utah sits
The same service costs 2.6 times more in Hawaii than in Washington, DC. 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· 21st of 51
$398
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.