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 $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.26 Typical High $1.26 | Professional | None | $1.10 | $1.26 | $1.26 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $1.62 Typical High $1.86 | Facility | None | $1.45 | $1.62 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Molina Setting Professional Modifier None Typical Low $1.02 Median $1.10 Typical High $1.45 | Professional | None | $1.02 | $1.10 | $1.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.74 Median $2.19 Typical High $4.90 | Facility | None | $1.74 | $2.19 | $4.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.32 | Professional | None | $1.20 | $1.20 | $1.32 |
Select Health Setting Facility Modifier None Typical Low $1.12 Median $1.17 Typical High $3.63 | Facility | None | $1.12 | $1.17 | $3.63 |
Select Health Setting Professional Modifier None Typical Low $0.87 Median $1.12 Typical High $1.12 | Professional | None | $0.87 | $1.12 | $1.12 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $0.98 Median $1.32 Typical High $2.04 | Professional | None | $0.98 | $1.32 | $2.04 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
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 $0.55 Median $0.63 Typical High $0.63 | Professional | 52 · Reduced service | $0.55 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.25 Typical High $0.25 | Professional | 53 · Discontinued | $0.22 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.17 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.11 | $0.13 | $0.13 |
Where Utah sits
The same service costs 2.7 times more in Wyoming than in Alabama. 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· 32nd of 51
$1.10
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.