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 $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $47.86 | Professional | None | $26.92 | $26.92 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $87.10 | Professional | None | $54.95 | $67.61 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $87.10 Median $93.33 Typical High $141.25 | Facility | None | $87.10 | $93.33 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Select Health Setting Professional Modifier None Typical Low $46.77 Median $91.20 Typical High $93.33 | Professional | None | $46.77 | $91.20 | $93.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $109.65 | Professional | None | $57.54 | $75.86 | $109.65 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $74.13 | Professional | None | $32.36 | $41.69 | $74.13 |
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 $13.49 Median $13.49 Typical High $15.14 | Professional | 52 · Reduced service | $13.49 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $6.17 | Professional | 53 · Discontinued | $5.37 | $5.37 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.57 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $3.02 |
Where Utah sits
The same service costs 2.6 times more in Kansas than in Arizona. 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· 30th of 51
$52.48
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.