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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $208.93 | Professional | None | $102.33 | $165.96 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $223.87 Typical High $338.84 | Facility | None | $213.80 | $223.87 | $338.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | None | $162.18 | $162.18 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $251.19 | Professional | None | $114.82 | $229.09 | $251.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $302.00 | Professional | None | $141.25 | $181.97 | $302.00 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Facility | None | $151.36 | $151.36 | $158.49 |
United Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $181.97 | Professional | None | $87.10 | $112.20 | $181.97 |
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 $36.31 Median $36.31 Typical High $48.98 | Professional | 52 · Reduced service | $36.31 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $19.50 | Professional | 53 · Discontinued | $14.45 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $14.45 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $9.77 |
Where Utah sits
The same service costs 3.2 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· 27th of 51
$162
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.