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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | None | $141.25 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $407.38 | Professional | None | $199.53 | $323.59 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $416.87 Median $436.52 Typical High $660.69 | Facility | None | $416.87 | $436.52 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $446.68 Typical High $537.03 | Professional | None | $223.87 | $446.68 | $537.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $645.65 | Professional | None | $275.42 | $363.08 | $645.65 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Facility | None | $213.80 | $213.80 | $257.04 |
United Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $354.81 | Professional | None | $173.78 | $218.78 | $354.81 |
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 $70.79 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $70.79 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $28.18 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $16.60 |
Where Utah sits
The same service costs 2.5 times more in Hawaii 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· 22nd of 51
$316
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.