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 $70.79 Median $2,951.21 Typical High $4,570.88 | Facility | None | $70.79 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $204.17 | Professional | None | $70.79 | $112.20 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $213.80 | Professional | None | $64.57 | $134.90 | $213.80 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $138.04 | Professional | None | $93.33 | $112.20 | $138.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $141.25 Typical High $190.55 | Professional | None | $63.10 | $141.25 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $199.53 | Professional | None | $53.70 | $93.33 | $199.53 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $48.98 Median $147.91 Typical High $288.40 | Professional | None | $48.98 | $147.91 | $288.40 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $5,128.61 | Facility | None | $1,698.24 | $4,466.84 | $5,128.61 |
United Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $275.42 | Professional | None | $50.12 | $114.82 | $275.42 |
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 $34.67 Median $56.23 Typical High $100.00 | Professional | 52 · Reduced service | $34.67 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.39 Typical High $40.74 | Professional | 53 · Discontinued | $14.13 | $22.39 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.98 Typical High $30.20 | Professional | 55 · Aftercare only | $10.47 | $16.98 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $7.08 | $11.22 | $20.42 |
Where Utah sits
The same service costs 2.7 times more in Wisconsin than in Maryland. 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
$115
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.