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 $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | None | $6.31 | $6.31 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | None | $9.77 | $9.77 | $13.49 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $60.26 | Professional | None | $14.45 | $14.45 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $18.62 Median $19.50 Typical High $29.51 | Facility | None | $18.62 | $19.50 | $29.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | None | $14.13 | $14.13 | $14.79 |
Select Health Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Select Health Setting Professional Modifier None Typical Low $10.00 Median $19.95 Typical High $21.38 | Professional | None | $10.00 | $19.95 | $21.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $25.70 | Professional | None | $12.30 | $16.22 | $25.70 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None Typical Low $7.76 Median $9.77 Typical High $15.85 | Professional | None | $7.76 | $9.77 | $15.85 |
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 $3.16 Median $3.16 Typical High $3.39 | Professional | 52 · Reduced service | $3.16 | $3.16 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.26 Typical High $1.35 | Professional | 53 · Discontinued | $1.26 | $1.26 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $0.95 Typical High $1.00 | Professional | 55 · Aftercare only | $0.95 | $0.95 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.63 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.63 | $0.63 | $0.68 |
Where Utah sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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
$13.18
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.