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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $53.70 Typical High $53.70 | Professional | None | $36.31 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $89.13 | Professional | None | $43.65 | $60.26 | $89.13 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $34.67 | Professional | None | $25.12 | $28.84 | $34.67 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $56.23 | Professional | None | $35.48 | $41.69 | $56.23 |
Select Health Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Select Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | None | $34.67 | $34.67 | $37.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $100.00 | Professional | None | $40.74 | $53.70 | $100.00 |
United Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $89.13 | Professional | None | $48.98 | $53.70 | $89.13 |
3 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 $18.20 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $18.20 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $5.50 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.63 | $5.37 | $5.37 |
Where Utah sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 47th of 51
$41.69
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.