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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | None | $190.55 | $190.55 | $257.04 |
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 $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $549.54 | Professional | None | $269.15 | $436.52 | $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 $426.58 Median $426.58 Typical High $457.09 | Professional | None | $426.58 | $426.58 | $457.09 |
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 $660.69 | Professional | None | $302.00 | $602.56 | $660.69 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $794.33 | Professional | None | $371.54 | $478.63 | $794.33 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $478.63 | Professional | None | $229.09 | $295.12 | $478.63 |
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 $95.50 Median $95.50 Typical High $128.82 | Professional | 52 · Reduced service | $95.50 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | 53 · Discontinued | $38.02 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $25.70 |
Where Utah sits
The same service costs 3.7 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· 27th 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.