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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $19.95 | Professional | None | $17.38 | $17.38 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $58.88 | Professional | None | $43.65 | $43.65 | $58.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $91.20 | Facility | None | $57.54 | $60.26 | $91.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $58.88 Typical High $61.66 | Professional | None | $30.90 | $58.88 | $61.66 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $70.79 | Professional | None | $38.02 | $48.98 | $70.79 |
United Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $48.98 | Professional | None | $20.89 | $26.92 | $48.98 |
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 $8.51 Median $8.51 Typical High $10.00 | Professional | 52 · Reduced service | $8.51 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.98 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $2.00 |
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· 25th of 51
$33.11
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.