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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $64.57 Typical High $64.57 | Professional | None | $13.18 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $13.18 Typical High $85.11 | Professional | None | $10.00 | $13.18 | $85.11 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $21.88 Typical High $24.55 | Professional | None | $10.23 | $21.88 | $24.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $117.49 | Facility | None | $61.66 | $81.28 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $18.20 | Professional | None | $15.49 | $18.20 | $18.20 |
Select Health Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $11.75 Median $19.95 Typical High $25.70 | Professional | None | $11.75 | $19.95 | $25.70 |
United Setting Professional Modifier None Typical Low $11.22 Median $12.88 Typical High $151.36 | Professional | None | $11.22 | $12.88 | $151.36 |
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 $6.61 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $6.61 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $2.63 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $2.00 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $1.32 | $6.46 | $6.46 |
Where Utah sits
The same service costs 43.7 times more in Hawaii 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· 15th of 51
$18.20
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.