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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | None | $141.25 | $141.25 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $501.19 | Professional | None | $245.47 | $389.05 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $812.83 | Facility | None | $512.86 | $537.03 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $524.81 Typical High $549.54 | Professional | None | $275.42 | $524.81 | $549.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $616.60 | Professional | None | $338.84 | $436.52 | $616.60 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Facility | None | $281.84 | $281.84 | $288.40 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $426.58 | Professional | None | $169.82 | $218.78 | $426.58 |
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 $70.79 Median $70.79 Typical High $93.33 | Professional | 52 · Reduced service | $70.79 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | 53 · Discontinued | $28.18 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $28.18 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $18.62 |
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
$302
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.