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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $26.92 | Professional | None | $19.50 | $19.50 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $61.66 | Professional | None | $48.98 | $48.98 | $61.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $63.10 Median $66.07 Typical High $100.00 | Facility | None | $63.10 | $66.07 | $100.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | None | $47.86 | $47.86 | $57.54 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $67.61 Typical High $83.18 | Professional | None | $33.88 | $67.61 | $83.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $95.50 | Professional | None | $41.69 | $53.70 | $95.50 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
United Setting Professional Modifier None Typical Low $23.44 Median $30.20 Typical High $53.70 | Professional | None | $23.44 | $30.20 | $53.70 |
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 $9.77 Median $9.77 Typical High $12.59 | Professional | 52 · Reduced service | $9.77 | $9.77 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $5.13 | Professional | 53 · Discontinued | $3.89 | $3.89 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $3.80 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.51 |
Where Utah sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 20th of 51
$47.86
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.