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 $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $60.26 | Professional | None | $21.38 | $21.38 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $28.18 Median $29.51 Typical High $44.67 | Facility | None | $28.18 | $29.51 | $44.67 |
Regence BlueShield Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Select Health Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Select Health Setting Professional Modifier None Typical Low $15.14 Median $28.84 Typical High $30.20 | Professional | None | $15.14 | $28.84 | $30.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $33.88 | Professional | None | $18.62 | $23.99 | $33.88 |
United Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $16.60 | Facility | None | $14.45 | $14.45 | $16.60 |
United Setting Professional Modifier None Typical Low $10.47 Median $13.18 Typical High $23.44 | Professional | None | $10.47 | $13.18 | $23.44 |
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 $4.27 Median $4.27 Typical High $5.37 | Professional | 52 · Reduced service | $4.27 | $4.27 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $2.19 | Professional | 53 · Discontinued | $1.70 | $1.70 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.62 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $1.07 |
Where Utah sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 31st of 51
$18.62
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.