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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | None | $26.30 | $26.30 | $30.90 |
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 $56.23 Median $67.61 Typical High $85.11 | Professional | None | $56.23 | $67.61 | $85.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $89.13 Median $93.33 Typical High $141.25 | Facility | None | $89.13 | $93.33 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Select Health Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $95.50 | Professional | None | $47.86 | $91.20 | $95.50 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $109.65 | Professional | None | $58.88 | $75.86 | $109.65 |
United Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $74.13 | Professional | None | $32.36 | $40.74 | $74.13 |
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 $13.18 Median $13.18 Typical High $15.49 | Professional | 52 · Reduced service | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | 53 · Discontinued | $5.25 | $5.25 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.57 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $3.09 |
Where Utah sits
The same service costs 2.3 times more in Montana than in Florida. 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· 22nd of 51
$56.23
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.