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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | None | $186.21 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $724.44 | Professional | None | $354.81 | $562.34 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $1,174.90 | Facility | None | $741.31 | $776.25 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $794.33 | Professional | None | $398.11 | $707.95 | $794.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $891.25 | Professional | None | $489.78 | $630.96 | $891.25 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $575.44 | Professional | None | $229.09 | $288.40 | $575.44 |
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 $93.33 Median $93.33 Typical High $125.89 | Professional | 52 · Reduced service | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $38.02 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $25.12 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $25.12 |
Where Utah sits
The same service costs 3.0 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· 17th of 51
$479
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.