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 $61.66 Median $61.66 Typical High $109.65 | Facility | None | $61.66 | $61.66 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $109.65 | Professional | None | $61.66 | $66.07 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $85.11 Typical High $87.10 | Facility | None | $81.28 | $85.11 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $102.33 | Professional | None | $53.70 | $87.10 | $102.33 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $100.00 | Professional | None | $72.44 | $85.11 | $100.00 |
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 $54.95 Median $102.33 Typical High $131.83 | Professional | None | $54.95 | $102.33 | $131.83 |
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 $46.77 Median $54.95 Typical High $64.57 | Professional | None | $46.77 | $54.95 | $64.57 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $190.55 | Professional | None | $54.95 | $112.20 | $190.55 |
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 $40.74 Median $72.44 Typical High $120.23 | Professional | None | $40.74 | $72.44 | $120.23 |
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 $30.90 Median $33.11 Typical High $54.95 | Professional | 52 · Reduced service | $30.90 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $21.88 | Professional | 53 · Discontinued | $12.30 | $13.18 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $16.60 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $10.96 |
Where Utah sits
The same service costs 3.9 times more in Alaska 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· 22nd of 51
$83.18
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.