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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $58.88 | Professional | None | $41.69 | $41.69 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $162.18 | Professional | None | $77.62 | $125.89 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $162.18 Median $169.82 Typical High $263.03 | Facility | None | $162.18 | $169.82 | $263.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $173.78 | Professional | None | $87.10 | $158.49 | $173.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $194.98 | Professional | None | $107.15 | $141.25 | $194.98 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Facility | None | $79.43 | $79.43 | $85.11 |
United Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $125.89 | Professional | None | $50.12 | $64.57 | $125.89 |
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 $20.89 Median $20.89 Typical High $29.51 | Professional | 52 · Reduced service | $20.89 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $11.75 | Professional | 53 · Discontinued | $8.32 | $8.32 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $8.71 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $5.89 |
Where Utah sits
The same service costs 5.1 times more in Kansas 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· 26th of 51
$81.28
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.