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 $38.02 Median $38.02 Typical High $60.26 | Facility | None | $38.02 | $38.02 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $42.66 Typical High $60.26 | Professional | None | $25.70 | $42.66 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $95.50 | Professional | None | $38.02 | $60.26 | $95.50 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $37.15 | Professional | None | $23.44 | $29.51 | $37.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $177.83 | Facility | None | $97.72 | $123.03 | $177.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $31.62 Median $64.57 Typical High $83.18 | Professional | None | $31.62 | $64.57 | $83.18 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $102.33 | Professional | None | $35.48 | $70.79 | $102.33 |
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 $27.54 Median $48.98 Typical High $95.50 | Professional | None | $27.54 | $48.98 | $95.50 |
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 $15.14 Median $22.91 Typical High $30.20 | Professional | 52 · Reduced service | $15.14 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $9.12 Typical High $12.30 | Professional | 53 · Discontinued | $6.03 | $9.12 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $6.76 Typical High $9.12 | Professional | 55 · Aftercare only | $4.57 | $6.76 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $4.57 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.02 | $4.57 | $6.03 |
Where Utah sits
The same service costs 3.5 times more in Wisconsin 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
$38.02
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.