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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $17.38 | Professional | None | $15.14 | $15.14 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | None | $26.30 | $26.30 | $36.31 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $79.43 | Facility | None | $50.12 | $52.48 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Select Health Setting Professional Modifier None Typical Low $26.92 Median $51.29 Typical High $53.70 | Professional | None | $26.92 | $51.29 | $53.70 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $61.66 | Professional | None | $33.11 | $42.66 | $61.66 |
United Setting Professional Modifier None Typical Low $18.20 Median $23.44 Typical High $42.66 | Professional | None | $18.20 | $23.44 | $42.66 |
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 $7.59 Median $7.59 Typical High $8.71 | Professional | 52 · Reduced service | $7.59 | $7.59 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.47 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.57 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.74 |
Where Utah sits
The same service costs 2.1 times more in Montana than in Alabama. 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· 20th of 51
$36.31
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.