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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $70.79 | Professional | None | $45.71 | $54.95 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $114.82 | Facility | None | $72.44 | $75.86 | $114.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $77.62 | Professional | None | $38.90 | $74.13 | $77.62 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $89.13 | Professional | None | $47.86 | $61.66 | $89.13 |
United Setting Professional Modifier None Typical Low $26.30 Median $33.11 Typical High $60.26 | Professional | None | $26.30 | $33.11 | $60.26 |
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 $10.72 Median $10.72 Typical High $12.59 | Professional | 52 · Reduced service | $10.72 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $5.01 | Professional | 53 · Discontinued | $4.37 | $4.37 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.72 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.51 |
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· 26th of 51
$41.69
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.