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 $0.50 Median $0.50 Typical High $0.50 | Facility | None | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.56 | Professional | None | $0.50 | $0.50 | $0.56 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.15 | Facility | None | $1.10 | $1.10 | $1.15 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
Molina Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.78 | Professional | None | $1.32 | $1.32 | $1.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Select Health Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | None | $1.82 | $1.82 | $1.82 |
Select Health Setting Professional Modifier None Typical Low $0.91 Median $1.82 Typical High $1.82 | Professional | None | $0.91 | $1.82 | $1.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1.20 Median $1.51 Typical High $2.19 | Professional | None | $1.20 | $1.51 | $2.19 |
United Setting Professional Modifier None Typical Low $0.60 Median $0.78 Typical High $1.51 | Professional | None | $0.60 | $0.78 | $1.51 |
4 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 $0.25 Median $0.25 Typical High $0.28 | Professional | 52 · Reduced service | $0.25 | $0.25 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
Where Utah sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 35th of 51
$1.10
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.