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 $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $9.33 Typical High $9.33 | Professional | None | $8.13 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $9.55 Typical High $10.96 | Facility | None | $8.32 | $9.55 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $9.77 | Professional | None | $7.24 | $7.24 | $9.77 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Select Health Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Select Health Setting Professional Modifier None Typical Low $3.55 Median $8.51 Typical High $8.51 | Professional | None | $3.55 | $8.51 | $8.51 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1.32 Median $2.19 Typical High $8.91 | Professional | None | $1.32 | $2.19 | $8.91 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $4.07 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $4.07 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $1.62 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.23 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.81 | $0.93 | $0.93 |
Where Utah sits
Rates are fairly even across states for this service. 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· 20th of 51
$8.13
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.