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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $29.51 | Professional | None | $21.38 | $21.38 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $63.10 | Professional | None | $41.69 | $50.12 | $63.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $104.71 | Facility | None | $66.07 | $69.18 | $104.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $67.61 Typical High $70.79 | Professional | None | $35.48 | $67.61 | $70.79 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $81.28 | Professional | None | $43.65 | $56.23 | $81.28 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $54.95 | Professional | None | $25.70 | $33.11 | $54.95 |
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 $10.72 Median $10.72 Typical High $14.79 | Professional | 52 · Reduced service | $10.72 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $5.89 | Professional | 53 · Discontinued | $4.27 | $4.27 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $4.47 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.95 |
Where Utah sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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
$43.65
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.