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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $16.98 | Professional | None | $14.45 | $14.45 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $50.12 | Professional | None | $34.67 | $37.15 | $50.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $77.62 | Facility | None | $48.98 | $51.29 | $77.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Select Health Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Select Health Setting Professional Modifier None Typical Low $26.30 Median $50.12 Typical High $52.48 | Professional | None | $26.30 | $50.12 | $52.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $60.26 | Professional | None | $32.36 | $41.69 | $60.26 |
United Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $40.74 | Professional | None | $17.78 | $22.39 | $40.74 |
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 $7.24 Median $7.24 Typical High $8.51 | Professional | 52 · Reduced service | $7.24 | $7.24 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $3.39 | Professional | 53 · Discontinued | $2.88 | $2.88 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.51 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.70 |
Where Utah sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 19th of 51
$33.88
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.