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 $43.65 Median $43.65 Typical High $107.15 | Facility | None | $43.65 | $43.65 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $107.15 | Professional | None | $41.69 | $51.29 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $69.18 Typical High $104.71 | Professional | None | $26.30 | $69.18 | $104.71 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $100.00 | Professional | None | $70.79 | $83.18 | $100.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $389.05 | Facility | None | $204.17 | $263.03 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $128.82 | Professional | None | $36.31 | $56.23 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $45.71 Median $128.82 Typical High $169.82 | Professional | None | $45.71 | $128.82 | $169.82 |
United Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $95.50 | Professional | None | $28.18 | $41.69 | $95.50 |
5 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 $20.89 Median $25.70 Typical High $53.70 | Professional | 52 · Reduced service | $20.89 | $25.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.23 Typical High $21.38 | Professional | 53 · Discontinued | $8.32 | $10.23 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $16.22 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.92 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.17 | $6.92 | $10.72 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Utah sits
The same service costs 3.5 times more in Hawaii than in Maryland. 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· 13th of 51
$77.62
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.