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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | None | $123.03 | $123.03 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $398.11 | Professional | None | $194.98 | $309.03 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $426.58 Typical High $645.65 | Facility | None | $407.38 | $426.58 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $436.52 | Professional | None | $218.78 | $416.87 | $436.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $478.63 | Professional | None | $269.15 | $346.74 | $478.63 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $354.81 | Professional | None | $147.91 | $190.55 | $354.81 |
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 $61.66 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $24.55 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $14.79 |
Where Utah sits
The same service costs 2.5 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· 26th of 51
$282
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.