How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $812.83 | Professional | None | $120.23 | $144.54 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $204.17 | Professional | None | $141.25 | $147.91 | $204.17 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $102.33 | Professional | None | $74.13 | $85.11 | $102.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $169.82 | Professional | None | $120.23 | $141.25 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $323.59 | Facility | None | $109.65 | $141.25 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | None | $120.23 | $138.04 | $147.91 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $245.47 | Professional | None | $107.15 | $158.49 | $245.47 |
United Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $190.55 | Professional | None | $107.15 | $125.89 | $190.55 |
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 $60.26 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $23.99 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.02 | $14.45 | $14.45 |
Where Utah sits
The same service costs 3.2 times more in Alaska 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
$97.72
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.