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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | None | $151.36 | $151.36 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $446.68 | Facility | None | $416.87 | $416.87 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $501.19 | Professional | None | $239.88 | $380.19 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | None | $371.54 | $371.54 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $537.03 | Professional | None | $269.15 | $537.03 | $537.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $645.65 | Professional | None | $331.13 | $426.58 | $645.65 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $416.87 | Professional | None | $186.21 | $234.42 | $416.87 |
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 $75.86 Median $75.86 Typical High $85.11 | Professional | 52 · Reduced service | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $16.98 |
Where Utah sits
The same service costs 2.5 times more in Montana than in New York. 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
$355
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.