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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $19.95 | Professional | None | $9.55 | $9.55 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $60.26 | Professional | None | $21.88 | $21.88 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $28.18 Median $30.20 Typical High $45.71 | Facility | None | $28.18 | $30.20 | $45.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $28.18 | Professional | None | $21.38 | $21.38 | $28.18 |
Select Health Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Select Health Setting Professional Modifier None Typical Low $15.14 Median $30.20 Typical High $40.74 | Professional | None | $15.14 | $30.20 | $40.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $43.65 | Professional | None | $18.62 | $23.99 | $43.65 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Facility | None | $19.95 | $19.95 | $28.18 |
United Setting Professional Modifier None Typical Low $11.75 Median $14.79 Typical High $23.99 | Professional | None | $11.75 | $14.79 | $23.99 |
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 $4.79 Median $4.79 Typical High $6.46 | Professional | 52 · Reduced service | $4.79 | $4.79 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $1.95 Typical High $2.57 | Professional | 53 · Discontinued | $1.95 | $1.95 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.95 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.29 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.29 |
Where Utah sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 28th of 51
$19.05
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.