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 $25.12 Median $25.12 Typical High $37.15 | Facility | None | $25.12 | $25.12 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $33.11 Typical High $38.90 | Professional | None | $25.12 | $33.11 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $39.81 Typical High $43.65 | Professional | None | $28.84 | $39.81 | $43.65 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $28.18 Typical High $34.67 | Professional | None | $23.44 | $28.18 | $34.67 |
Regence BlueShield Setting Facility Modifier None Typical Low $47.86 Median $53.70 Typical High $72.44 | Facility | None | $47.86 | $53.70 | $72.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $44.67 | Professional | None | $22.91 | $33.88 | $44.67 |
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 $22.39 Median $25.12 Typical High $38.02 | Professional | None | $22.39 | $25.12 | $38.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $77.62 | Professional | None | $25.70 | $45.71 | $77.62 |
United Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $53.70 | Professional | None | $22.39 | $33.11 | $53.70 |
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 $12.59 Median $14.79 Typical High $18.62 | Professional | 52 · Reduced service | $12.59 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.47 Typical High $5.50 | Professional | 55 · Aftercare only | $3.80 | $4.47 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.95 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.51 | $2.95 | $3.72 |
Where Utah sits
The same service costs 2.8 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· 45th of 51
$30.20
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.