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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $41.69 | Professional | None | $20.89 | $20.89 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $61.66 | Professional | None | $38.90 | $47.86 | $61.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $100.00 | Facility | None | $61.66 | $66.07 | $100.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $50.12 | Professional | None | $46.77 | $46.77 | $50.12 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Select Health Setting Professional Modifier None Typical Low $33.11 Median $66.07 Typical High $70.79 | Professional | None | $33.11 | $66.07 | $70.79 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $85.11 | Professional | None | $40.74 | $53.70 | $85.11 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $52.48 | Professional | None | $25.70 | $32.36 | $52.48 |
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 $10.47 Median $10.47 Typical High $14.79 | Professional | 52 · Reduced service | $10.47 | $10.47 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $5.89 | Professional | 53 · Discontinued | $4.17 | $4.17 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $4.47 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.95 |
Where Utah sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 37th of 51
$40.74
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.