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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $74.13 | Professional | None | $47.86 | $58.88 | $74.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $120.23 | Facility | None | $75.86 | $79.43 | $120.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Select Health Setting Professional Modifier None Typical Low $40.74 Median $81.28 Typical High $107.15 | Professional | None | $40.74 | $81.28 | $107.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $114.82 | Professional | None | $50.12 | $64.57 | $114.82 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Facility | None | $53.70 | $53.70 | $64.57 |
United Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $64.57 | Professional | None | $30.90 | $39.81 | $64.57 |
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 $12.88 Median $12.88 Typical High $17.38 | Professional | 52 · Reduced service | $12.88 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.92 | Professional | 53 · Discontinued | $5.13 | $5.13 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $5.13 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $3.47 |
Where Utah sits
The same service costs 4.9 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· 37th of 51
$51.29
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.