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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | None | $37.15 | $37.15 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $117.49 | Professional | None | $60.26 | $91.20 | $117.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $117.49 Median $125.89 Typical High $190.55 | Facility | None | $117.49 | $125.89 | $190.55 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $125.89 | Professional | None | $63.10 | $120.23 | $125.89 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $141.25 | Professional | None | $77.62 | $102.33 | $141.25 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
United Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $100.00 | Professional | None | $45.71 | $57.54 | $100.00 |
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 $18.62 Median $18.62 Typical High $26.30 | Professional | 52 · Reduced service | $18.62 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $10.47 | Professional | 53 · Discontinued | $7.41 | $7.41 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $7.94 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $5.25 |
Where Utah sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 27th 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.