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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $33.88 | Professional | None | $29.51 | $29.51 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $95.50 | Professional | None | $60.26 | $75.86 | $95.50 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $104.71 Typical High $158.49 | Facility | None | $97.72 | $104.71 | $158.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $104.71 | Professional | None | $52.48 | $102.33 | $104.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $123.03 | Professional | None | $64.57 | $85.11 | $123.03 |
United Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $83.18 | Professional | None | $35.48 | $45.71 | $83.18 |
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 $14.79 Median $14.79 Typical High $16.98 | Professional | 52 · Reduced service | $14.79 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.13 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.39 |
Where Utah sits
The same service costs 2.6 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· 27th of 51
$57.54
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.