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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | None | $51.29 | $51.29 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $154.88 | Professional | None | $74.13 | $120.23 | $154.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $158.49 Median $165.96 Typical High $251.19 | Facility | None | $158.49 | $165.96 | $251.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | None | $117.49 | $117.49 | $134.90 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $190.55 | Professional | None | $85.11 | $169.82 | $190.55 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $229.09 | Professional | None | $102.33 | $134.90 | $229.09 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Facility | None | $102.33 | $102.33 | $107.15 |
United Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $131.83 | Professional | None | $61.66 | $79.43 | $131.83 |
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 $25.70 Median $25.70 Typical High $34.67 | Professional | 52 · Reduced service | $25.70 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $13.80 | Professional | 53 · Discontinued | $10.23 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $10.23 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.92 |
Where Utah sits
The same service costs 4.1 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· 28th of 51
$102
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.