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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | None | $204.17 | $204.17 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $199.53 | Professional | None | $138.04 | $190.55 | $199.53 |
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 Facility Modifier None Typical Low $144.54 Median $173.78 Typical High $234.42 | Facility | None | $144.54 | $173.78 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $144.54 | Professional | None | $123.03 | $128.82 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $199.53 | Professional | None | $131.83 | $190.55 | $199.53 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $269.15 | Professional | None | $120.23 | $186.21 | $269.15 |
United Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $194.98 | Professional | None | $107.15 | $131.83 | $194.98 |
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 $83.18 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $33.11 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.60 | $20.42 | $20.42 |
Where Utah sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 40th of 51
$126
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.