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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $323.59 | Professional | None | $158.49 | $257.04 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $346.74 Typical High $537.03 | Facility | None | $331.13 | $346.74 | $537.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | None | $251.19 | $251.19 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $354.81 Typical High $436.52 | Professional | None | $177.83 | $354.81 | $436.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $512.86 | Professional | None | $218.78 | $288.40 | $512.86 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
United Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $281.84 | Professional | None | $138.04 | $173.78 | $281.84 |
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 $56.23 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $56.23 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $15.14 |
Where Utah sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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
$245
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.