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 $229.09 | Professional | None | $223.87 | $223.87 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
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 $851.14 Typical High $933.25 | Professional | None | $467.74 | $851.14 | $933.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,047.13 | Professional | None | $575.44 | $758.58 | $1,047.13 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $346.74 | Facility | None | $257.04 | $257.04 | $346.74 |
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 $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | 53 · Discontinued | $44.67 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.91 |
Where Utah sits
The same service costs 2.8 times more in Montana 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· 22nd of 51
$479
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.