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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | None | $36.31 | $36.31 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $120.23 | Professional | None | $60.26 | $93.33 | $120.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $128.82 Typical High $194.98 | Facility | None | $123.03 | $128.82 | $194.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $131.83 | Professional | None | $66.07 | $125.89 | $131.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $151.36 | Professional | None | $81.28 | $104.71 | $151.36 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $102.33 | Professional | None | $44.67 | $56.23 | $102.33 |
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 $18.20 Median $18.20 Typical High $21.38 | Professional | 52 · Reduced service | $18.20 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $8.51 | Professional | 53 · Discontinued | $7.24 | $7.24 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.31 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.27 |
Where Utah sits
The same service costs 2.6 times more in Hawaii 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· 28th of 51
$70.79
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.