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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $190.55 | Professional | None | $93.33 | $147.91 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $194.98 Median $204.17 Typical High $309.03 | Facility | None | $194.98 | $204.17 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $208.93 | Professional | None | $104.71 | $186.21 | $208.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $234.42 | Professional | None | $128.82 | $165.96 | $234.42 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Facility | None | $60.26 | $60.26 | $75.86 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $151.36 | Professional | None | $60.26 | $75.86 | $151.36 |
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 $24.55 Median $24.55 Typical High $25.12 | Professional | 52 · Reduced service | $24.55 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.01 |
Where Utah sits
The same service costs 2.9 times more in Montana 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· 24th of 51
$105
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.