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 $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $60.26 | Professional | None | $19.05 | $19.05 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $25.12 Median $26.30 Typical High $39.81 | Facility | None | $25.12 | $26.30 | $39.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $22.91 | Professional | None | $18.62 | $18.62 | $22.91 |
Select Health Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Select Health Setting Professional Modifier None Typical Low $13.49 Median $26.92 Typical High $32.36 | Professional | None | $13.49 | $26.92 | $32.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $16.60 Median $21.38 Typical High $38.02 | Professional | None | $16.60 | $21.38 | $38.02 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $16.22 | Facility | None | $12.88 | $12.88 | $16.22 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.30 Typical High $20.89 | Professional | None | $9.77 | $12.30 | $20.89 |
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 $3.98 Median $3.98 Typical High $5.25 | Professional | 52 · Reduced service | $3.98 | $3.98 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.58 Typical High $2.09 | Professional | 53 · Discontinued | $1.58 | $1.58 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.58 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $1.05 |
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· 26th of 51
$16.60
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.