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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $70.79 | Professional | None | $45.71 | $45.71 | $70.79 |
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 $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $147.91 | Professional | None | $72.44 | $117.49 | $147.91 |
Regence BlueShield Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $239.88 | Facility | None | $151.36 | $158.49 | $239.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $162.18 | Professional | None | $81.28 | $158.49 | $162.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $186.21 | Professional | None | $100.00 | $128.82 | $186.21 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $128.82 | Professional | None | $54.95 | $70.79 | $128.82 |
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 $22.91 Median $22.91 Typical High $26.30 | Professional | 52 · Reduced service | $22.91 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.25 |
Where Utah sits
The same service costs 2.8 times more in Kansas 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
$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.