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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | None | $169.82 | $169.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $562.34 | Professional | None | $275.42 | $446.68 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $575.44 Median $602.56 Typical High $912.01 | Facility | None | $575.44 | $602.56 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $616.60 Typical High $616.60 | Professional | None | $309.03 | $616.60 | $616.60 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $741.31 | Professional | None | $380.19 | $489.78 | $741.31 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $331.13 | Facility | None | $257.04 | $257.04 | $331.13 |
United Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $489.78 | Professional | None | $204.17 | $263.03 | $489.78 |
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 $85.11 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $31.62 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $21.38 |
Where Utah sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 19th of 51
$398
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.