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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | None | $61.66 | $61.66 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $181.97 | Professional | None | $87.10 | $141.25 | $181.97 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $194.98 Typical High $295.12 | Facility | None | $186.21 | $194.98 | $295.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | None | $138.04 | $138.04 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $208.93 | Professional | None | $97.72 | $199.53 | $208.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $251.19 | Professional | None | $120.23 | $158.49 | $251.19 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Facility | None | $100.00 | $100.00 | $120.23 |
United Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $154.88 | Professional | None | $75.86 | $95.50 | $154.88 |
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 $30.90 Median $30.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $12.30 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $7.76 |
Where Utah sits
The same service costs 2.9 times more in Hawaii than in Florida. 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
$126
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.