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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | None | $33.88 | $33.88 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $134.90 | Professional | None | $64.57 | $102.33 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $213.80 | Facility | None | $134.90 | $141.25 | $213.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $144.54 | Professional | None | $72.44 | $128.82 | $144.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $158.49 | Professional | None | $89.13 | $114.82 | $158.49 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Facility | None | $70.79 | $70.79 | $83.18 |
United Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $102.33 | Professional | None | $41.69 | $52.48 | $102.33 |
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 $16.98 Median $16.98 Typical High $21.88 | Professional | 52 · Reduced service | $16.98 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $8.71 | Professional | 53 · Discontinued | $6.76 | $6.76 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $6.46 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $4.37 |
Where Utah sits
The same service costs 4.4 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
$69.18
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.