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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $34.67 | Professional | None | $30.20 | $30.20 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $100.00 | Professional | None | $60.26 | $77.62 | $100.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $107.15 Typical High $162.18 | Facility | None | $100.00 | $107.15 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $107.15 | Professional | None | $53.70 | $104.71 | $107.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $125.89 | Professional | None | $66.07 | $87.10 | $125.89 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $60.26 | Facility | None | $32.36 | $32.36 | $60.26 |
United Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $85.11 | Professional | None | $36.31 | $46.77 | $85.11 |
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 $15.14 Median $15.14 Typical High $17.38 | Professional | 52 · Reduced service | $15.14 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | 53 · Discontinued | $6.03 | $6.03 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $5.25 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.47 |
Where Utah sits
The same service costs 2.1 times more in Montana than in Florida. 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
$67.61
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.