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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $18.20 | Professional | None | $16.60 | $17.78 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $20.42 Typical High $28.18 | Professional | None | $19.50 | $20.42 | $28.18 |
Molina Setting Professional Modifier None Typical Low $12.88 Median $27.54 Typical High $60.26 | Professional | None | $12.88 | $27.54 | $60.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $23.99 | Professional | None | $16.98 | $19.95 | $23.99 |
Select Health Setting Facility Modifier None Typical Low $18.20 Median $23.44 Typical High $45.71 | Facility | None | $18.20 | $23.44 | $45.71 |
Select Health Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $24.55 | Professional | None | $18.20 | $20.89 | $24.55 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $16.60 Median $24.55 Typical High $63.10 | Professional | None | $16.60 | $24.55 | $63.10 |
United Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $26.92 | Professional | None | $14.79 | $16.22 | $26.92 |
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 $8.32 Median $8.91 Typical High $9.12 | Professional | 52 · Reduced service | $8.32 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.55 Typical High $3.72 | Professional | 53 · Discontinued | $3.31 | $3.55 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.69 Typical High $2.75 | Professional | 55 · Aftercare only | $2.45 | $2.69 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.78 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.66 | $1.78 | $1.82 |
Where Utah sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 23rd of 51
$19.95
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.