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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | None | $45.71 | $45.71 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $131.83 | Professional | None | $63.10 | $102.33 | $131.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $213.80 | Facility | None | $134.90 | $141.25 | $213.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $144.54 Typical High $177.83 | Professional | None | $72.44 | $144.54 | $177.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $173.78 | Professional | None | $89.13 | $114.82 | $173.78 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $87.10 | Facility | None | $70.79 | $70.79 | $87.10 |
United Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $112.20 | Professional | None | $54.95 | $70.79 | $112.20 |
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 $22.39 Median $22.39 Typical High $30.20 | Professional | 52 · Reduced service | $22.39 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $12.02 | Professional | 53 · Discontinued | $9.12 | $9.12 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $8.91 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.03 |
Where Utah sits
The same service costs 2.6 times more in Hawaii 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· 33rd of 51
$89.13
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.