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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | None | $21.88 | $21.88 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $70.79 | Professional | None | $44.67 | $54.95 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $114.82 | Facility | None | $70.79 | $75.86 | $114.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | None | $53.70 | $53.70 | $54.95 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $75.86 Typical High $79.43 | Professional | None | $38.02 | $75.86 | $79.43 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $93.33 | Professional | None | $46.77 | $61.66 | $93.33 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $60.26 | Professional | None | $26.30 | $33.88 | $60.26 |
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 $10.96 Median $10.96 Typical High $13.18 | Professional | 52 · Reduced service | $10.96 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $5.25 | Professional | 53 · Discontinued | $4.37 | $4.37 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.98 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.63 |
Where Utah sits
The same service costs 2.9 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· 45th of 51
$36.31
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.