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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | None | $38.02 | $38.02 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $109.65 | Professional | None | $60.26 | $85.11 | $109.65 |
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 $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
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 $120.23 Typical High $158.49 | Professional | None | $60.26 | $120.23 | $158.49 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $169.82 | Professional | None | $74.13 | $95.50 | $169.82 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $79.43 | Facility | None | $77.62 | $77.62 | $79.43 |
United Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $93.33 | Professional | None | $45.71 | $58.88 | $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 $19.05 Median $19.05 Typical High $26.92 | Professional | 52 · Reduced service | $19.05 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $10.72 | Professional | 53 · Discontinued | $7.59 | $7.59 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $7.94 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $5.37 |
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· 26th of 51
$74.13
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.