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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | None | $63.10 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $87.10 | Facility | None | $67.61 | $75.86 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $64.57 Typical High $64.57 | Professional | None | $31.62 | $64.57 | $64.57 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $11.48 Median $63.10 Typical High $75.86 | Professional | None | $11.48 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
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 $31.62 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $31.62 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $12.59 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $9.55 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.31 | $7.24 | $7.24 |
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· 36th of 51
$63.10
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.