How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | None | $54.95 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $107.15 | Facility | None | $61.66 | $69.18 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $102.33 Median $147.91 Typical High $204.17 | Facility | None | $102.33 | $147.91 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Select Health Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $56.23 | Professional | None | $42.66 | $56.23 | $56.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $81.28 | Professional | None | $48.98 | $60.26 | $81.28 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
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 $27.54 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $27.54 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $8.32 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.50 | $6.31 | $6.31 |
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· 28th of 51
$56.23
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.