How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | None | $36.31 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $27.54 Typical High $33.88 | Professional | None | $23.44 | $27.54 | $33.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $117.49 | Facility | None | $61.66 | $81.28 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $47.86 | Professional | None | $40.74 | $47.86 | $47.86 |
Select Health Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $70.79 | Professional | None | $38.02 | $58.88 | $70.79 |
United Setting Professional Modifier None Typical Low $26.30 Median $36.31 Typical High $45.71 | Professional | None | $26.30 | $36.31 | $45.71 |
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 $18.20 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $18.20 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $7.41 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.50 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.63 | $4.07 | $4.07 |
Where Utah sits
The same service costs 12.9 times more in Hawaii than in Kentucky. 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· 48th of 51
$33.88
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.