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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Molina Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $60.26 | Professional | None | $13.80 | $13.80 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $17.78 Median $19.05 Typical High $28.84 | Facility | None | $17.78 | $19.05 | $28.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $15.85 | Professional | None | $13.49 | $13.49 | $15.85 |
Select Health Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Select Health Setting Professional Modifier None Typical Low $9.55 Median $19.05 Typical High $22.91 | Professional | None | $9.55 | $19.05 | $22.91 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $11.75 Median $15.49 Typical High $27.54 | Professional | None | $11.75 | $15.49 | $27.54 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.88 | Facility | None | $12.59 | $12.59 | $12.88 |
United Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $15.14 | Professional | None | $7.41 | $9.33 | $15.14 |
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 $3.02 Median $3.02 Typical High $4.07 | Professional | 52 · Reduced service | $3.02 | $3.02 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.62 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $1.23 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.81 |
Where Utah sits
The same service costs 3.0 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· 33rd of 51
$13.49
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.