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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $93.33 | Professional | None | $60.26 | $72.44 | $93.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $151.36 | Facility | None | $93.33 | $100.00 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $97.72 Typical High $100.00 | Professional | None | $50.12 | $97.72 | $100.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $117.49 | Professional | None | $61.66 | $81.28 | $117.49 |
United Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $79.43 | Professional | None | $33.88 | $43.65 | $79.43 |
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 $16.22 | Professional | 52 · Reduced service | $14.13 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $6.61 | Professional | 53 · Discontinued | $5.62 | $5.62 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.90 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $3.24 |
Where Utah sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 22nd of 51
$67.61
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.