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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $125.89 | Professional | None | $42.66 | $42.66 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $63.10 | Professional | 52 · Reduced service | $21.38 | $21.38 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $25.12 | Professional | 53 · Discontinued | $8.51 | $8.51 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $19.05 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $134.90 | Professional | None | $109.65 | $109.65 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $147.91 Typical High $223.87 | Facility | None | $141.25 | $147.91 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $169.82 | Professional | None | $109.65 | $147.91 | $169.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $223.87 | Professional | None | $114.82 | $151.36 | $223.87 |
United Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $95.50 | Professional | None | $60.26 | $66.07 | $95.50 |
3 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Utah sits
The same service costs 2.4 times more in Montana than in Utah. 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· 51st of 51
$64.57
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.