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 $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.91 Typical High $0.91 | Professional | None | $0.79 | $0.91 | $0.91 |
Cigna Setting Facility Modifier None Typical Low $0.87 Median $0.98 Typical High $1.12 | Facility | None | $0.87 | $0.98 | $1.12 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Molina Setting Professional Modifier None Typical Low $0.76 Median $0.79 Typical High $1.00 | Professional | None | $0.76 | $0.79 | $1.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.23 Median $1.58 Typical High $2.19 | Facility | None | $1.23 | $1.58 | $2.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $0.95 | Professional | None | $0.87 | $0.87 | $0.95 |
Select Health Setting Facility Modifier None Typical Low $0.83 Median $0.85 Typical High $1.38 | Facility | None | $0.83 | $0.85 | $1.38 |
Select Health Setting Professional Modifier None Typical Low $0.65 Median $0.83 Typical High $0.83 | Professional | None | $0.65 | $0.83 | $0.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $0.72 Median $0.87 Typical High $1.20 | Professional | None | $0.72 | $0.87 | $1.20 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
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 $0.40 Median $0.46 Typical High $0.46 | Professional | 52 · Reduced service | $0.40 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.18 Typical High $0.18 | Professional | 53 · Discontinued | $0.16 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.12 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.09 | $0.09 |
Where Utah sits
Rates are fairly even across states for this service. 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· 48th of 51
$0.79
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.