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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $478.63 | Professional | None | $234.42 | $380.19 | $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 $371.54 Median $371.54 Typical High $478.63 | Professional | None | $371.54 | $371.54 | $478.63 |
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 $263.03 Median $524.81 Typical High $676.08 | Professional | None | $263.03 | $524.81 | $676.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $758.58 | Professional | None | $323.59 | $426.58 | $758.58 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $416.87 | Facility | None | $346.74 | $346.74 | $416.87 |
United Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $416.87 | Professional | None | $204.17 | $257.04 | $416.87 |
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 $83.18 Median $83.18 Typical High $112.20 | Professional | 52 · Reduced service | $83.18 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | 53 · Discontinued | $33.11 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $22.39 |
Where Utah sits
The same service costs 3.7 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
$363
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.