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 $109.65 Median $109.65 Typical High $138.04 | Facility | None | $109.65 | $109.65 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $138.04 | Professional | None | $97.72 | $114.82 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $162.18 | Professional | None | $81.28 | $107.15 | $162.18 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $134.90 | Professional | None | $95.50 | $112.20 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $158.49 | Professional | None | $107.15 | $134.90 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $263.03 | Professional | None | $123.03 | $181.97 | $263.03 |
United Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $134.90 | Professional | None | $83.18 | $109.65 | $134.90 |
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 $48.98 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $48.98 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.39 Typical High $27.54 | Professional | 53 · Discontinued | $19.50 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $13.80 |
Where Utah sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 22nd of 51
$115
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.