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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $44.67 | Professional | None | $36.31 | $36.31 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $107.15 | Professional | None | $60.26 | $83.18 | $107.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $109.65 Median $114.82 Typical High $173.78 | Facility | None | $109.65 | $114.82 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $117.49 Typical High $138.04 | Professional | None | $57.54 | $117.49 | $138.04 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $165.96 | Professional | None | $70.79 | $93.33 | $165.96 |
United Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $64.57 | Facility | None | $48.98 | $48.98 | $64.57 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $91.20 | Professional | None | $44.67 | $56.23 | $91.20 |
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 $18.20 Median $18.20 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.47 |
Where Utah sits
The same service costs 2.2 times more in Hawaii 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· 21st of 51
$81.28
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.