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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $6.17 Typical High $6.17 | Professional | None | $5.37 | $6.17 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $7.59 Typical High $10.23 | Facility | None | $6.76 | $7.59 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $6.92 | Professional | None | $4.90 | $5.25 | $6.92 |
Regence BlueShield Setting Facility Modifier None Typical Low $11.75 Median $16.22 Typical High $25.70 | Facility | None | $11.75 | $16.22 | $25.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Select Health Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Select Health Setting Professional Modifier None Typical Low $4.27 Median $5.50 Typical High $5.50 | Professional | None | $4.27 | $5.50 | $5.50 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $4.79 Median $5.75 Typical High $7.76 | Professional | None | $4.79 | $5.75 | $7.76 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
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 $2.69 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.69 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.07 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.79 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.52 | $0.62 | $0.62 |
Where Utah sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 43rd of 51
$5.25
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.