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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | None | $134.90 | $134.90 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | None | $104.71 | $104.71 | $154.88 |
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 $128.82 Median $144.54 Typical High $194.98 | Facility | None | $128.82 | $144.54 | $194.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $134.90 | Professional | None | $114.82 | $120.23 | $134.90 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $169.82 | Professional | None | $109.65 | $162.18 | $169.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $213.80 | Professional | None | $100.00 | $151.36 | $213.80 |
United Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $162.18 | Professional | None | $81.28 | $107.15 | $162.18 |
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 $57.54 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $13.49 |
Where Utah sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 23rd of 51
$117
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.