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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $60.26 | Professional | None | $38.90 | $46.77 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $61.66 Median $64.57 Typical High $97.72 | Facility | None | $61.66 | $64.57 | $97.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None | $46.77 | $46.77 | $54.95 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Select Health Setting Professional Modifier None Typical Low $33.11 Median $66.07 Typical High $79.43 | Professional | None | $33.11 | $66.07 | $79.43 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $93.33 | Professional | None | $40.74 | $52.48 | $93.33 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
United Setting Professional Modifier None Typical Low $22.91 Median $28.84 Typical High $52.48 | Professional | None | $22.91 | $28.84 | $52.48 |
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 $9.33 Median $9.33 Typical High $12.02 | Professional | 52 · Reduced service | $9.33 | $9.33 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $4.79 | Professional | 53 · Discontinued | $3.72 | $3.72 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.55 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $2.40 |
Where Utah sits
The same service costs 3.0 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· 29th of 51
$38.90
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.