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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $316.23 | Professional | None | $239.88 | $239.88 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $707.95 | Professional | None | $338.84 | $549.54 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $707.95 Median $758.58 Typical High $1,148.15 | Facility | None | $707.95 | $758.58 | $1,148.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | None | $537.03 | $537.03 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $758.58 Typical High $891.25 | Professional | None | $380.19 | $758.58 | $891.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,071.52 | Professional | None | $467.74 | $616.60 | $1,071.52 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $602.56 | Professional | None | $295.12 | $371.54 | $602.56 |
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 $120.23 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $63.10 | Professional | 53 · Discontinued | $47.86 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $31.62 |
Where Utah sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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· 27th of 51
$537
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.