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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | None | $204.17 | $204.17 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $588.84 | Professional | None | $288.40 | $467.74 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $630.96 Typical High $954.99 | Facility | None | $602.56 | $630.96 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | None | $457.09 | $457.09 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $870.96 | Professional | None | $323.59 | $645.65 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $912.01 | Professional | None | $398.11 | $524.81 | $912.01 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $380.19 | Facility | None | $302.00 | $302.00 | $380.19 |
United Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $512.86 | Professional | None | $251.19 | $316.23 | $512.86 |
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 $102.33 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $24.55 |
Where Utah sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 24th of 51
$457
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.