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 $97.72 Median $97.72 Typical High $112.20 | Facility | None | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $112.20 | Professional | None | $85.11 | $97.72 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $134.90 | Professional | None | $114.82 | $123.03 | $134.90 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $102.33 | Professional | None | $74.13 | $85.11 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $190.55 | Facility | None | $125.89 | $141.25 | $190.55 |
Regence BlueShield Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $120.23 | Professional | None | $83.18 | $102.33 | $120.23 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $100.00 | Professional | None | $79.43 | $91.20 | $100.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $190.55 | Professional | None | $83.18 | $125.89 | $190.55 |
United Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $151.36 | Professional | None | $83.18 | $102.33 | $151.36 |
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 $48.98 Median $48.98 Typical High $56.23 | Facility | 52 · Reduced service | $48.98 | $48.98 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $16.60 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $11.22 | Facility | 56 · Pre-op care only | $9.77 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $48.98 Typical High $56.23 | Professional | 52 · Reduced service | $41.69 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.79 Typical High $16.60 | Professional | 55 · Aftercare only | $12.59 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.77 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $9.77 | $11.22 |
Where Utah sits
The same service costs 2.5 times more in Alaska 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· 34th of 51
$97.72
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.