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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $21.88 | Professional | None | $19.05 | $19.05 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $61.66 | Professional | None | $48.98 | $48.98 | $61.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $63.10 Median $66.07 Typical High $100.00 | Facility | None | $63.10 | $66.07 | $100.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $66.07 Typical High $67.61 | Professional | None | $33.88 | $66.07 | $67.61 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $79.43 | Professional | None | $41.69 | $54.95 | $79.43 |
United Setting Professional Modifier None Typical Low $22.91 Median $29.51 Typical High $53.70 | Professional | None | $22.91 | $29.51 | $53.70 |
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 $9.55 Median $9.55 Typical High $10.96 | Professional | 52 · Reduced service | $9.55 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $4.37 | Professional | 53 · Discontinued | $3.80 | $3.80 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.31 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.19 |
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· 24th of 51
$37.15
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.