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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | None | $12.02 | $12.02 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $60.26 | Professional | None | $30.90 | $30.90 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $39.81 Median $41.69 Typical High $63.10 | Facility | None | $39.81 | $41.69 | $63.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Select Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Select Health Setting Professional Modifier None Typical Low $21.38 Median $40.74 Typical High $42.66 | Professional | None | $21.38 | $40.74 | $42.66 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $48.98 | Professional | None | $26.30 | $33.88 | $48.98 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $33.88 | Professional | None | $14.45 | $18.62 | $33.88 |
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 $5.89 Median $5.89 Typical High $6.92 | Professional | 52 · Reduced service | $5.89 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.75 | Professional | 53 · Discontinued | $2.40 | $2.40 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $2.04 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.38 |
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· 28th of 51
$22.91
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.