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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $45.71 | Professional | None | $30.90 | $30.90 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $91.20 | Professional | None | $60.26 | $69.18 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $91.20 Median $95.50 Typical High $144.54 | Facility | None | $91.20 | $95.50 | $144.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $85.11 | Professional | None | $67.61 | $67.61 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $120.23 | Professional | None | $48.98 | $97.72 | $120.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $138.04 | Professional | None | $60.26 | $77.62 | $138.04 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Facility | None | $60.26 | $60.26 | $63.10 |
United Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $77.62 | Professional | None | $37.15 | $47.86 | $77.62 |
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 $15.49 Median $15.49 Typical High $19.95 | Professional | 52 · Reduced service | $15.49 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.94 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $6.03 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.98 |
Where Utah sits
The same service costs 3.8 times more in Hawaii 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· 26th of 51
$63.10
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.