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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $16.22 | Professional | None | $14.13 | $14.13 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | None | $36.31 | $36.31 | $48.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $46.77 Median $48.98 Typical High $75.86 | Facility | None | $46.77 | $48.98 | $75.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Select Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Select Health Setting Professional Modifier None Typical Low $25.12 Median $48.98 Typical High $50.12 | Professional | None | $25.12 | $48.98 | $50.12 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $58.88 | Professional | None | $30.90 | $40.74 | $58.88 |
United Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $39.81 | Professional | None | $16.98 | $21.88 | $39.81 |
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 $7.08 Median $7.08 Typical High $8.13 | Professional | 52 · Reduced service | $7.08 | $7.08 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $3.24 | Professional | 53 · Discontinued | $2.82 | $2.82 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.45 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.62 |
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· 23rd of 51
$27.54
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.