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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | None | $85.11 | $85.11 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $309.03 | Professional | None | $147.91 | $239.88 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $309.03 Median $331.13 Typical High $501.19 | Facility | None | $309.03 | $331.13 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | None | $234.42 | $234.42 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $331.13 Typical High $363.08 | Professional | None | $165.96 | $331.13 | $363.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $436.52 | Professional | None | $204.17 | $269.15 | $436.52 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
United Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $263.03 | Professional | None | $104.71 | $131.83 | $263.03 |
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 $42.66 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $16.98 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.12 |
Where Utah sits
The same service costs 2.8 times more in Montana 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· 24th of 51
$182
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.