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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $11.75 | Professional | None | $10.23 | $10.23 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $60.26 | Professional | None | $25.70 | $25.70 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $33.88 Median $35.48 Typical High $53.70 | Facility | None | $33.88 | $35.48 | $53.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Select Health Setting Professional Modifier None Typical Low $18.20 Median $35.48 Typical High $36.31 | Professional | None | $18.20 | $35.48 | $36.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $22.39 Median $28.84 Typical High $41.69 | Professional | None | $22.39 | $28.84 | $41.69 |
United Setting Professional Modifier None Typical Low $12.30 Median $15.85 Typical High $28.84 | Professional | None | $12.30 | $15.85 | $28.84 |
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 $5.13 Median $5.13 Typical High $5.89 | Professional | 52 · Reduced service | $5.13 | $5.13 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $2.34 | Professional | 53 · Discontinued | $2.04 | $2.04 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.78 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.17 |
Where Utah sits
The same service costs 2.1 times more in Montana than in West Virginia. 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· 24th of 51
$22.39
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.