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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $64.57 | Professional | None | $32.36 | $32.36 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $93.33 | Professional | None | $60.26 | $74.13 | $93.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $151.36 | Facility | None | $95.50 | $100.00 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | None | $72.44 | $72.44 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $102.33 Typical High $112.20 | Professional | None | $51.29 | $102.33 | $112.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $134.90 | Professional | None | $63.10 | $81.28 | $134.90 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Facility | None | $67.61 | $67.61 | $77.62 |
United Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $81.28 | Professional | None | $38.90 | $50.12 | $81.28 |
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 $16.22 Median $16.22 Typical High $22.91 | Professional | 52 · Reduced service | $16.22 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $9.12 | Professional | 53 · Discontinued | $6.46 | $6.46 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $6.92 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $4.57 |
Where Utah sits
The same service costs 4.1 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· 41st of 51
$60.26
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.