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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $12.88 | Professional | None | $10.96 | $10.96 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $60.26 | Professional | None | $28.18 | $28.18 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $37.15 Median $38.90 Typical High $58.88 | Facility | None | $37.15 | $38.90 | $58.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Select Health Setting Professional Modifier None Typical Low $19.95 Median $38.02 Typical High $39.81 | Professional | None | $19.95 | $38.02 | $39.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $45.71 | Professional | None | $24.55 | $31.62 | $45.71 |
United Setting Professional Modifier None Typical Low $13.49 Median $16.98 Typical High $30.90 | Professional | None | $13.49 | $16.98 | $30.90 |
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 $5.50 Median $5.50 Typical High $6.31 | Professional | 52 · Reduced service | $5.50 | $5.50 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $2.51 | Professional | 53 · Discontinued | $2.19 | $2.19 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.91 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.29 |
Where Utah sits
The same service costs 2.2 times more in Montana than in New Jersey. 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
$24.55
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.