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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | None | $37.15 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $48.98 Typical High $56.23 | Facility | None | $42.66 | $48.98 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $46.77 | Professional | None | $36.31 | $36.31 | $46.77 |
Regence BlueShield Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $100.00 | Facility | None | $36.31 | $36.31 | $100.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $38.02 | Professional | None | $28.84 | $38.02 | $38.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $53.70 | Professional | None | $33.11 | $39.81 | $53.70 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $18.20 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $18.20 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.50 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.27 | $4.27 |
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· 45th of 51
$36.31
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.