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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $38.02 | Professional | None | $29.51 | $29.51 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $112.20 | Professional | None | $60.26 | $87.10 | $112.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $114.82 Median $120.23 Typical High $181.97 | Facility | None | $114.82 | $120.23 | $181.97 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $123.03 | Professional | None | $61.66 | $114.82 | $123.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $134.90 | Professional | None | $74.13 | $97.72 | $134.90 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Facility | None | $61.66 | $61.66 | $63.10 |
United Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $89.13 | Professional | None | $36.31 | $45.71 | $89.13 |
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 $14.79 Median $14.79 Typical High $19.05 | Professional | 52 · Reduced service | $14.79 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.59 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.80 |
Where Utah sits
The same service costs 4.3 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· 23rd of 51
$63.10
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.