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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $407.38 | Professional | None | $194.98 | $316.23 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $416.87 Median $436.52 Typical High $660.69 | Facility | None | $416.87 | $436.52 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $446.68 | Professional | None | $223.87 | $398.11 | $446.68 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $489.78 | Professional | None | $275.42 | $354.81 | $489.78 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Facility | None | $181.97 | $181.97 | $218.78 |
United Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $316.23 | Professional | None | $125.89 | $162.18 | $316.23 |
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 $52.48 Median $52.48 Typical High $70.79 | Professional | 52 · Reduced service | $52.48 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $28.18 | Professional | 53 · Discontinued | $20.89 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $20.89 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $14.13 |
Where Utah sits
The same service costs 3.3 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· 26th of 51
$224
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.