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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $302.00 | Professional | None | $223.87 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $870.96 | Professional | None | $416.87 | $676.08 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $870.96 Median $933.25 Typical High $1,412.54 | Facility | None | $870.96 | $933.25 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $933.25 Typical High $933.25 | Professional | None | $467.74 | $933.25 | $933.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,122.02 | Professional | None | $575.44 | $758.58 | $1,122.02 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $467.74 | Facility | None | $426.58 | $426.58 | $467.74 |
United Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $676.08 | Professional | None | $269.15 | $346.74 | $676.08 |
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 $112.20 Median $112.20 Typical High $151.36 | Professional | 52 · Reduced service | $112.20 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | 53 · Discontinued | $44.67 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $30.20 |
Where Utah sits
The same service costs 3.0 times more in Hawaii than in West Virginia. 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
$501
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.