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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | None | $33.11 | $33.11 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Facility | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $107.15 | Professional | None | $60.26 | $83.18 | $107.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $109.65 Median $114.82 Typical High $173.78 | Facility | None | $109.65 | $114.82 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $112.20 Typical High $117.49 | Professional | None | $58.88 | $112.20 | $117.49 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $134.90 | Professional | None | $72.44 | $93.33 | $134.90 |
United Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $93.33 | Professional | None | $39.81 | $51.29 | $93.33 |
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 $16.22 Median $16.22 Typical High $18.20 | Professional | 52 · Reduced service | $16.22 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.63 |
Where Utah sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 23rd of 51
$79.43
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.