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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | None | $70.79 | $70.79 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $208.93 | Professional | None | $100.00 | $162.18 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $223.87 Typical High $338.84 | Facility | None | $213.80 | $223.87 | $338.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $302.00 | Professional | None | $112.20 | $229.09 | $302.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $323.59 | Professional | None | $138.04 | $181.97 | $323.59 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $177.83 | Professional | None | $87.10 | $109.65 | $177.83 |
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 $35.48 Median $35.48 Typical High $47.86 | Professional | 52 · Reduced service | $35.48 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | 53 · Discontinued | $14.45 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $14.45 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $9.55 |
Where Utah sits
The same service costs 3.5 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· 30th of 51
$138
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.