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 $42.66 Median $42.66 Typical High $45.71 | Facility | None | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $45.71 | Professional | None | $35.48 | $42.66 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Molina Setting Professional Modifier None Typical Low $18.20 Median $43.65 Typical High $60.26 | Professional | None | $18.20 | $43.65 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $39.81 Median $44.67 Typical High $58.88 | Facility | None | $39.81 | $44.67 | $58.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $37.15 | Professional | None | $26.92 | $31.62 | $37.15 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Select Health Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $31.62 | Professional | None | $22.91 | $27.54 | $31.62 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $63.10 | Professional | None | $25.70 | $38.90 | $63.10 |
United Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $47.86 | Professional | None | $23.99 | $28.84 | $47.86 |
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 $17.78 Median $21.38 Typical High $22.91 | Professional | 52 · Reduced service | $17.78 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $7.08 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.46 Typical High $6.92 | Professional | 55 · Aftercare only | $5.37 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.27 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.55 | $4.27 | $4.57 |
Where Utah sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 32nd of 51
$31.62
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.