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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $309.03 | Professional | None | $213.80 | $213.80 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $380.19 | Professional | None | $234.42 | $234.42 | $380.19 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $208.93 | Professional | None | $138.04 | $169.82 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $588.84 | Facility | None | $323.59 | $407.38 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | None | $239.88 | $275.42 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $354.81 | Professional | None | $223.87 | $309.03 | $354.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $426.58 | Professional | None | $181.97 | $288.40 | $426.58 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $346.74 | Professional | None | $181.97 | $208.93 | $346.74 |
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 $107.15 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $42.66 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $23.99 |
Where Utah sits
The same service costs 3.0 times more in Wisconsin 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· 41st of 51
$219
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.