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 $27.54 Median $27.54 Typical High $46.77 | Facility | None | $27.54 | $27.54 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $46.77 | Professional | None | $26.30 | $30.90 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $31.62 Typical High $50.12 | Professional | None | $19.05 | $31.62 | $50.12 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $33.88 | Professional | None | $22.91 | $27.54 | $33.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $74.13 | Facility | None | $48.98 | $54.95 | $74.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $51.29 | Professional | None | $26.30 | $39.81 | $51.29 |
Select Health Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $70.79 | Professional | None | $33.11 | $52.48 | $70.79 |
United Setting Professional Modifier None Typical Low $19.50 Median $32.36 Typical High $40.74 | Professional | None | $19.50 | $32.36 | $40.74 |
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 $13.18 Median $15.49 Typical High $23.44 | Professional | 52 · Reduced service | $13.18 | $15.49 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.17 Typical High $9.33 | Professional | 53 · Discontinued | $5.25 | $6.17 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.57 Typical High $6.92 | Professional | 55 · Aftercare only | $3.98 | $4.57 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.09 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.63 | $3.09 | $4.68 |
Where Utah sits
The same service costs 2.7 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· 37th of 51
$30.90
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.