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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | None | $117.49 | $117.49 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $416.87 | Professional | None | $204.17 | $323.59 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $426.58 Median $446.68 Typical High $676.08 | Facility | None | $426.58 | $446.68 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $457.09 | Professional | None | $229.09 | $436.52 | $457.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $524.81 | Professional | None | $281.84 | $363.08 | $524.81 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
United Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $354.81 | Professional | None | $141.25 | $181.97 | $354.81 |
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 $58.88 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $23.44 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.30 |
Where Utah sits
The same service costs 2.7 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· 25th of 51
$245
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.