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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $48.98 | Professional | None | $34.67 | $34.67 | $48.98 |
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 $79.43 Typical High $100.00 | Professional | None | $60.26 | $79.43 | $100.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $162.18 | Facility | None | $102.33 | $107.15 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $128.82 | Professional | None | $54.95 | $109.65 | $128.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $154.88 | Professional | None | $67.61 | $87.10 | $154.88 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
United Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $87.10 | Professional | None | $41.69 | $53.70 | $87.10 |
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 $17.38 Median $17.38 Typical High $24.55 | Professional | 52 · Reduced service | $17.38 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $9.77 | Professional | 53 · Discontinued | $6.92 | $6.92 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $7.41 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $4.90 |
Where Utah sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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· 29th of 51
$67.61
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.