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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | None | $208.93 | $208.93 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $602.56 | Professional | None | $288.40 | $467.74 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $977.24 | Facility | None | $616.60 | $645.65 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | None | $457.09 | $457.09 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $831.76 | Professional | None | $331.13 | $660.69 | $831.76 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $933.25 | Professional | None | $407.38 | $524.81 | $933.25 |
United Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $512.86 | Professional | None | $251.19 | $323.59 | $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 $104.71 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $23.99 |
Where Utah sits
The same service costs 2.8 times more in Wisconsin 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· 37th of 51
$398
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.