How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | None | $57.54 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $83.18 | Facility | None | $64.57 | $72.44 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $147.91 | Facility | None | $83.18 | $109.65 | $147.91 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Select Health Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | None | $45.71 | $58.88 | $58.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $85.11 | Professional | None | $51.29 | $63.10 | $85.11 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $28.84 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $28.84 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $11.48 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $8.71 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.75 | $6.61 | $6.61 |
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· 21st of 51
$57.54
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.