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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $81.28 | Professional | None | $52.48 | $64.57 | $81.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $83.18 Median $87.10 Typical High $134.90 | Facility | None | $83.18 | $87.10 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $44.67 Median $89.13 Typical High $112.20 | Professional | None | $44.67 | $89.13 | $112.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $107.15 | Professional | None | $54.95 | $72.44 | $107.15 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Facility | None | $58.88 | $58.88 | $60.26 |
United Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $70.79 | Professional | None | $34.67 | $43.65 | $70.79 |
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 $14.13 Median $14.13 Typical High $19.95 | Professional | 52 · Reduced service | $14.13 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $7.94 | Professional | 53 · Discontinued | $5.62 | $5.62 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $6.03 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $3.98 |
Where Utah sits
The same service costs 3.6 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· 34th of 51
$56.23
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.