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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | None | $26.30 | $26.30 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | None | $58.88 | $58.88 | $77.62 |
Regence BlueShield Setting Facility Modifier None Typical Low $77.62 Median $81.28 Typical High $123.03 | Facility | None | $77.62 | $81.28 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Select Health Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $87.10 | Professional | None | $41.69 | $83.18 | $87.10 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $104.71 | Professional | None | $51.29 | $66.07 | $104.71 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $45.71 | Facility | None | $41.69 | $41.69 | $45.71 |
United Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $64.57 | Professional | None | $31.62 | $40.74 | $64.57 |
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 $13.18 Median $13.18 Typical High $15.85 | Professional | 52 · Reduced service | $13.18 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $6.31 | Professional | 53 · Discontinued | $5.25 | $5.25 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.79 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $3.16 |
Where Utah sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 24th of 51
$57.54
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.