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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $58.88 | Professional | None | $28.84 | $28.84 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $64.57 | Facility | None | $57.54 | $57.54 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $83.18 | Professional | None | $53.70 | $66.07 | $83.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $134.90 | Facility | None | $85.11 | $89.13 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | None | $64.57 | $64.57 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $112.20 | Professional | None | $45.71 | $91.20 | $112.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $131.83 | Professional | None | $58.88 | $74.13 | $131.83 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $72.44 | Professional | None | $35.48 | $44.67 | $72.44 |
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 $14.45 Median $14.45 Typical High $17.78 | Professional | 52 · Reduced service | $14.45 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $7.08 | Professional | 53 · Discontinued | $5.75 | $5.75 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.25 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.55 |
Where Utah sits
The same service costs 2.6 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· 44th of 51
$53.70
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.