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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $478.63 | Professional | None | $229.09 | $371.54 | $478.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $489.78 Median $512.86 Typical High $776.25 | Facility | None | $489.78 | $512.86 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | None | $363.08 | $363.08 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $524.81 Typical High $562.34 | Professional | None | $257.04 | $524.81 | $562.34 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $676.08 | Professional | None | $316.23 | $416.87 | $676.08 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Facility | None | $288.40 | $288.40 | $389.05 |
United Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $407.38 | Professional | None | $169.82 | $213.80 | $407.38 |
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 $69.18 Median $69.18 Typical High $93.33 | Professional | 52 · Reduced service | $69.18 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $37.15 | Professional | 53 · Discontinued | $27.54 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $28.18 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $18.62 |
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· 24th of 51
$295
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.