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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $43.65 Typical High $43.65 | Professional | None | $38.02 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $48.98 Typical High $56.23 | Facility | None | $43.65 | $48.98 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $48.98 | Professional | None | $37.15 | $37.15 | $48.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $100.00 | Facility | None | $56.23 | $72.44 | $100.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Select Health Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | None | $30.20 | $38.90 | $38.90 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $33.88 Median $41.69 Typical High $56.23 | Professional | None | $33.88 | $41.69 | $56.23 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
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 $19.05 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $19.05 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $7.59 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.75 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.80 | $4.37 | $4.37 |
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
$38.02
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.