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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | None | $33.11 | $33.11 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $107.15 | Professional | None | $60.26 | $85.11 | $107.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $112.20 Median $117.49 Typical High $177.83 | Facility | None | $112.20 | $117.49 | $177.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $120.23 | Professional | None | $60.26 | $114.82 | $120.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $138.04 | Professional | None | $74.13 | $95.50 | $138.04 |
United Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $93.33 | Professional | None | $40.74 | $51.29 | $93.33 |
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 $16.60 Median $16.60 Typical High $19.50 | Professional | 52 · Reduced service | $16.60 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.76 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.89 |
Where Utah sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 36th of 51
$63.10
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.