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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $75.86 | Professional | None | $58.88 | $58.88 | $75.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $77.62 Median $81.28 Typical High $123.03 | Facility | None | $77.62 | $81.28 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | None | $57.54 | $57.54 | $69.18 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Select Health Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $97.72 | Professional | None | $41.69 | $83.18 | $97.72 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $117.49 | Professional | None | $51.29 | $66.07 | $117.49 |
United Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $36.31 | Facility | None | $19.05 | $19.05 | $36.31 |
United Setting Professional Modifier None Typical Low $28.18 Median $36.31 Typical High $64.57 | Professional | None | $28.18 | $36.31 | $64.57 |
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 $11.75 Median $11.75 Typical High $12.30 | Professional | 52 · Reduced service | $11.75 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | 53 · Discontinued | $4.68 | $4.68 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $3.72 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.45 |
Where Utah sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 29th of 51
$46.77
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.