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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $501.19 | Professional | None | $245.47 | $389.05 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $812.83 | Facility | None | $512.86 | $537.03 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $549.54 | Professional | None | $275.42 | $537.03 | $549.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $645.65 | Professional | None | $338.84 | $436.52 | $645.65 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $398.11 | Professional | None | $158.49 | $199.53 | $398.11 |
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 $64.57 Median $64.57 Typical High $85.11 | Professional | 52 · Reduced service | $64.57 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $33.88 | Professional | 53 · Discontinued | $25.70 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $25.70 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $16.98 |
Where Utah sits
The same service costs 3.0 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· 33rd of 51
$275
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.