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 $85.11 | Professional | None | $72.44 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $245.47 | Professional | None | $120.23 | $194.98 | $245.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $251.19 Median $263.03 Typical High $398.11 | Facility | None | $251.19 | $263.03 | $398.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $269.15 | Professional | None | $134.90 | $257.04 | $269.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $302.00 | Professional | None | $165.96 | $213.80 | $302.00 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $213.80 | Professional | None | $87.10 | $112.20 | $213.80 |
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 $42.66 | Professional | 52 · Reduced service | $36.31 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $8.51 |
Where Utah sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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· 23rd of 51
$158
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.