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 $33.88 | Professional | None | $31.62 | $31.62 | $33.88 |
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 $60.26 Median $74.13 Typical High $97.72 | Professional | None | $60.26 | $74.13 | $97.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $102.33 Typical High $154.88 | Facility | None | $97.72 | $102.33 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $104.71 | Professional | None | $52.48 | $100.00 | $104.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $120.23 | Professional | None | $64.57 | $83.18 | $120.23 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $48.98 | Facility | None | $29.51 | $29.51 | $48.98 |
United Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $81.28 | Professional | None | $38.02 | $48.98 | $81.28 |
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 $15.85 Median $15.85 Typical High $16.98 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.01 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.39 |
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· 28th of 51
$61.66
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.