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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | None | $204.17 | $204.17 | $234.42 |
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 $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $660.69 | Professional | None | $323.59 | $524.81 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $707.95 Typical High $1,071.52 | Facility | None | $676.08 | $707.95 | $1,071.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | None | $512.86 | $512.86 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $741.31 | Professional | None | $363.08 | $724.44 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $891.25 | Professional | None | $446.68 | $575.44 | $891.25 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $575.44 | Professional | None | $245.47 | $316.23 | $575.44 |
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 $102.33 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $40.74 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $23.44 |
Where Utah sits
The same service costs 2.8 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
$407
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.