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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | None | $13.18 | $13.18 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | None | $33.88 | $33.88 | $45.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $44.67 Median $46.77 Typical High $70.79 | Facility | None | $44.67 | $46.77 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Select Health Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $45.71 Typical High $47.86 | Professional | None | $23.99 | $45.71 | $47.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $54.95 | Professional | None | $28.84 | $38.02 | $54.95 |
United Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $37.15 | Professional | None | $16.22 | $20.42 | $37.15 |
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 $6.61 Median $6.61 Typical High $7.59 | Professional | 52 · Reduced service | $6.61 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $3.09 | Professional | 53 · Discontinued | $2.63 | $2.63 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.29 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.51 |
Where Utah sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 24th of 51
$26.92
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.