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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | None | $229.09 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $831.76 | Professional | None | $407.38 | $660.69 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,348.96 | Facility | None | $851.14 | $891.25 | $1,348.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | None | $645.65 | $645.65 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $912.01 Typical High $954.99 | Professional | None | $457.09 | $912.01 | $954.99 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,148.15 | Professional | None | $562.34 | $741.31 | $1,148.15 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $691.83 | Professional | None | $275.42 | $354.81 | $691.83 |
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 $114.82 Median $114.82 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $30.20 |
Where Utah sits
The same service costs 2.8 times more in Iowa 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
$468
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.