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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | None | $38.90 | $38.90 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $114.82 | Professional | None | $60.26 | $89.13 | $114.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $114.82 Median $123.03 Typical High $186.21 | Facility | None | $114.82 | $123.03 | $186.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | None | $87.10 | $87.10 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $131.83 | Professional | None | $61.66 | $123.03 | $131.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $158.49 | Professional | None | $75.86 | $97.72 | $158.49 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Facility | None | $60.26 | $60.26 | $81.28 |
United Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $97.72 | Professional | None | $47.86 | $60.26 | $97.72 |
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 $19.50 Median $19.50 Typical High $26.92 | Professional | 52 · Reduced service | $19.50 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $10.96 | Professional | 53 · Discontinued | $7.76 | $7.76 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.13 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $5.50 |
Where Utah sits
The same service costs 3.1 times more in Hawaii 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· 30th of 51
$75.86
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.