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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $91.20 | Professional | None | $57.54 | $70.79 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $147.91 | Facility | None | $93.33 | $97.72 | $147.91 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | None | $69.18 | $69.18 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $102.33 | Professional | None | $50.12 | $100.00 | $102.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $123.03 | Professional | None | $61.66 | $79.43 | $123.03 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Facility | None | $47.86 | $47.86 | $64.57 |
United Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $77.62 | Professional | None | $38.02 | $48.98 | $77.62 |
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 $15.49 Median $15.49 Typical High $21.88 | Professional | 52 · Reduced service | $15.49 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $8.71 | Professional | 53 · Discontinued | $6.31 | $6.31 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $6.46 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $4.37 |
Where Utah sits
The same service costs 3.2 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· 30th of 51
$60.26
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.