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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | None | $25.70 | $25.70 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $83.18 | Professional | None | $53.70 | $66.07 | $83.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $134.90 | Facility | None | $85.11 | $89.13 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $91.20 | Professional | None | $45.71 | $89.13 | $91.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $107.15 | Professional | None | $56.23 | $74.13 | $107.15 |
United Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $72.44 | Professional | None | $30.90 | $39.81 | $72.44 |
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 $12.88 Median $12.88 Typical High $14.79 | Professional | 52 · Reduced service | $12.88 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.89 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $4.47 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.95 |
Where Utah sits
The same service costs 3.0 times more in Hawaii 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· 25th of 51
$50.12
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.