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 $165.96 Median $190.55 Typical High $223.87 | Facility | None | $165.96 | $190.55 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $223.87 | Professional | None | $165.96 | $190.55 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $281.84 | Professional | None | $223.87 | $245.47 | $281.84 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $204.17 | Professional | None | $147.91 | $169.82 | $204.17 |
Regence BlueShield Setting Facility Modifier None Typical Low $263.03 Median $288.40 Typical High $407.38 | Facility | None | $263.03 | $288.40 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $831.76 | Professional | None | $190.55 | $251.19 | $831.76 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $575.44 | Professional | None | $177.83 | $269.15 | $575.44 |
United Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $295.12 | Professional | None | $169.82 | $213.80 | $295.12 |
6 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 Facility Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $112.20 | Facility | 52 · Reduced service | $95.50 | $95.50 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $33.88 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $22.39 | Facility | 56 · Pre-op care only | $19.05 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $22.39 |
Where Utah sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 36th of 51
$195
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.