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 $70.79 Median $70.79 Typical High $97.72 | Facility | None | $70.79 | $70.79 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $114.82 | Professional | None | $70.79 | $97.72 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $131.83 | Professional | None | $81.28 | $109.65 | $131.83 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $138.04 | Professional | None | $97.72 | $112.20 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $213.80 | Facility | None | $141.25 | $158.49 | $213.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $131.83 | Professional | None | $81.28 | $102.33 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $112.20 | Professional | None | $83.18 | $95.50 | $112.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $213.80 | Professional | None | $89.13 | $138.04 | $213.80 |
United Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $158.49 | Professional | None | $72.44 | $97.72 | $158.49 |
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 $35.48 Median $44.67 Typical High $48.98 | Professional | 52 · Reduced service | $35.48 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $10.72 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.91 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.08 | $8.91 | $9.77 |
Where Utah sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 25th of 51
$110
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.