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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $63.10 | Professional | None | $44.67 | $44.67 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $141.25 | Professional | None | $67.61 | $109.65 | $141.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $229.09 | Facility | None | $144.54 | $151.36 | $229.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | None | $107.15 | $107.15 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $154.88 Typical High $190.55 | Professional | None | $75.86 | $154.88 | $190.55 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $218.78 | Professional | None | $93.33 | $123.03 | $218.78 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $114.82 | Facility | None | $93.33 | $93.33 | $114.82 |
United Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $120.23 | Professional | None | $53.70 | $69.18 | $120.23 |
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 $22.39 Median $22.39 Typical High $31.62 | Professional | 52 · Reduced service | $22.39 | $22.39 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $12.59 | Professional | 53 · Discontinued | $8.91 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $9.55 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $6.31 |
Where Utah sits
The same service costs 5.1 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· 26th of 51
$89.13
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.