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 $263.03 Typical High $4,570.88 | Facility | None | $63.10 | $263.03 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $147.91 Typical High $263.03 | Professional | None | $46.77 | $147.91 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $218.78 Typical High $302.00 | Professional | None | $58.88 | $218.78 | $302.00 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $208.93 | Professional | None | $141.25 | $165.96 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $117.49 Typical High $323.59 | Professional | None | $53.70 | $117.49 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $363.08 | Professional | None | $43.65 | $79.43 | $363.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $44.67 Median $251.19 Typical High $426.58 | Professional | None | $44.67 | $251.19 | $426.58 |
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 $43.65 Median $177.83 Typical High $426.58 | Professional | None | $43.65 | $177.83 | $426.58 |
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 $31.62 Median $50.12 Typical High $131.83 | Professional | 52 · Reduced service | $31.62 | $50.12 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $19.95 Typical High $52.48 | Professional | 53 · Discontinued | $12.59 | $19.95 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.14 Typical High $38.90 | Professional | 55 · Aftercare only | $9.33 | $15.14 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.00 Typical High $26.30 | Professional | 56 · Pre-op care only | $6.31 | $10.00 | $26.30 |
Where Utah sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 32nd of 51
$170
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.