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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $30.90 | Professional | None | $17.78 | $17.78 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $60.26 | Professional | None | $37.15 | $45.71 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $58.88 Median $61.66 Typical High $93.33 | Facility | None | $58.88 | $61.66 | $93.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Select Health Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $61.66 Typical High $63.10 | Professional | None | $31.62 | $61.66 | $63.10 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $72.44 | Professional | None | $38.90 | $50.12 | $72.44 |
United Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $50.12 | Professional | None | $21.38 | $27.54 | $50.12 |
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 $8.91 Median $8.91 Typical High $10.23 | Professional | 52 · Reduced service | $8.91 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $4.07 | Professional | 53 · Discontinued | $3.55 | $3.55 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $3.09 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $2.04 |
Where Utah sits
The same service costs 2.8 times more in Montana than in Kansas. 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· 30th of 51
$33.88
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.