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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | None | $87.10 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $125.89 | Facility | None | $95.50 | $109.65 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $60.26 | Professional | None | $30.20 | $44.67 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $131.83 | Facility | None | $95.50 | $117.49 | $131.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | None | $69.18 | $89.13 | $89.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $125.89 | Professional | None | $77.62 | $93.33 | $125.89 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $43.65 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $43.65 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $17.38 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $12.88 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.71 | $10.00 | $10.00 |
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· 33rd of 51
$85.11
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.