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 $0.56 Median $0.56 Typical High $0.56 | Facility | None | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.49 Median $0.56 Typical High $0.56 | Professional | None | $0.49 | $0.56 | $0.56 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $0.79 Typical High $1.29 | Facility | None | $0.71 | $0.79 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.26 Median $1.82 Typical High $2.51 | Facility | None | $1.26 | $1.82 | $2.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Select Health Setting Facility Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Facility | None | $0.52 | $0.52 | $0.52 |
Select Health Setting Professional Modifier None Typical Low $0.39 Median $0.51 Typical High $0.51 | Professional | None | $0.39 | $0.51 | $0.51 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $0.44 Median $0.52 Typical High $0.72 | Professional | None | $0.44 | $0.52 | $0.72 |
United Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
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 $0.25 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.25 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.10 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
Where Utah sits
The same service costs 2.6 times more in Wyoming than in Illinois. 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· 19th of 51
$0.52
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.