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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | None | $54.95 | $54.95 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $190.55 | Professional | None | $91.20 | $147.91 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $194.98 Median $204.17 Typical High $309.03 | Facility | None | $194.98 | $204.17 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $208.93 | Professional | None | $104.71 | $199.53 | $208.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $239.88 | Professional | None | $128.82 | $165.96 | $239.88 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $85.11 | Facility | None | $72.44 | $72.44 | $85.11 |
United Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $162.18 | Professional | None | $66.07 | $85.11 | $162.18 |
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 $27.54 Median $27.54 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.71 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.75 |
Where Utah sits
The same service costs 2.4 times more in Montana 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· 19th of 51
$120
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.