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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $549.54 | Professional | None | $478.63 | $501.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $812.83 | Professional | None | $562.34 | $562.34 | $812.83 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $537.03 | Professional | None | $389.05 | $446.68 | $537.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $691.83 | Professional | None | $489.78 | $575.44 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $1,318.26 | Facility | None | $524.81 | $676.08 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $707.95 | Professional | None | $537.03 | $616.60 | $707.95 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,778.28 | Professional | None | $478.63 | $691.83 | $1,778.28 |
United Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $776.25 | Professional | None | $407.38 | $446.68 | $776.25 |
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 $239.88 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $52.48 |
Where Utah sits
The same service costs 3.2 times more in Alaska than in New York. 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· 39th of 51
$501
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.