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 $21.88 Median $21.88 Typical High $93.33 | Facility | None | $21.88 | $21.88 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $33.88 Typical High $93.33 | Professional | None | $18.20 | $33.88 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $77.62 | Facility | None | $72.44 | $75.86 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $72.44 Typical High $91.20 | Professional | None | $21.38 | $72.44 | $91.20 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $67.61 | Professional | None | $46.77 | $56.23 | $67.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $257.04 Median $323.59 Typical High $467.74 | Facility | None | $257.04 | $323.59 | $467.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.50 Median $51.29 Typical High $114.82 | Professional | None | $19.50 | $51.29 | $114.82 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $16.98 Median $19.50 Typical High $22.39 | Professional | None | $16.98 | $19.50 | $22.39 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $20.42 Median $91.20 Typical High $147.91 | Professional | None | $20.42 | $91.20 | $147.91 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $14.79 Median $61.66 Typical High $107.15 | Professional | None | $14.79 | $61.66 | $107.15 |
5 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 $10.96 Median $16.98 Typical High $46.77 | Professional | 52 · Reduced service | $10.96 | $16.98 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $6.76 Typical High $18.62 | Professional | 53 · Discontinued | $4.37 | $6.76 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $5.13 Typical High $14.13 | Professional | 55 · Aftercare only | $3.24 | $5.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.39 Typical High $9.33 | Professional | 56 · Pre-op care only | $2.19 | $3.39 | $9.33 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $389.05 Median $489.78 Typical High $707.95 | Facility | 50 · Both sides | $389.05 | $489.78 | $707.95 |
Where Utah sits
The same service costs 5.9 times more in Iowa than in Kentucky. 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· 38th 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.