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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $64.57 | Professional | None | $31.62 | $31.62 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $123.03 | Professional | None | $60.26 | $95.50 | $123.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $199.53 | Facility | None | $123.03 | $131.83 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $131.83 | Professional | None | $66.07 | $120.23 | $131.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $147.91 | Professional | None | $81.28 | $107.15 | $147.91 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $100.00 | Facility | None | $64.57 | $64.57 | $100.00 |
United Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $95.50 | Professional | None | $38.02 | $48.98 | $95.50 |
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 $15.85 Median $15.85 Typical High $19.95 | Professional | 52 · Reduced service | $15.85 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $7.94 | Professional | 53 · Discontinued | $6.31 | $6.31 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $6.03 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.98 |
Where Utah sits
The same service costs 5.0 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· 27th of 51
$64.57
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.