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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $22.91 Typical High $22.91 | Professional | None | $14.45 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $22.91 Typical High $60.26 | Professional | None | $18.62 | $22.91 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $28.84 | Facility | None | $19.50 | $21.88 | $28.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $15.14 Median $16.22 Typical High $18.20 | Professional | None | $15.14 | $16.22 | $18.20 |
Select Health Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Select Health Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $19.50 | Professional | None | $15.85 | $17.78 | $19.50 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $14.79 Median $22.39 Typical High $34.67 | Professional | None | $14.79 | $22.39 | $34.67 |
United Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $24.55 | Professional | None | $13.18 | $15.49 | $24.55 |
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 $7.24 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $7.24 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $2.88 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $2.14 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.45 | $2.29 | $2.29 |
Where Utah sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 31st of 51
$16.22
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.