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 $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $60.26 | Professional | None | $16.98 | $16.98 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $22.39 Median $23.44 Typical High $35.48 | Facility | None | $22.39 | $23.44 | $35.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | None | $16.60 | $16.60 | $17.38 |
Select Health Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Select Health Setting Professional Modifier None Typical Low $12.02 Median $23.99 Typical High $24.55 | Professional | None | $12.02 | $23.99 | $24.55 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $14.79 Median $19.05 Typical High $29.51 | Professional | None | $14.79 | $19.05 | $29.51 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $18.62 | Professional | None | $9.12 | $11.75 | $18.62 |
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 $3.80 Median $3.80 Typical High $5.01 | Professional | 52 · Reduced service | $3.80 | $3.80 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.51 Typical High $2.04 | Professional | 53 · Discontinued | $1.51 | $1.51 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $1.51 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $1.00 |
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· 35th of 51
$16.22
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.