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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $87.10 | Professional | None | $60.26 | $67.61 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $87.10 Median $91.20 Typical High $138.04 | Facility | None | $87.10 | $91.20 | $138.04 |
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 $74.13 Typical High $109.65 | Professional | None | $57.54 | $74.13 | $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 $31.62 Median $40.74 Typical High $74.13 | Professional | None | $31.62 | $40.74 | $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 $13.18 Median $13.18 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.75 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $2.88 |
Where Utah sits
The same service costs 2.8 times more in Kansas 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· 24th of 51
$56.23
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.