How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $309.03 Median $346.74 Typical High $407.38 | Facility | None | $309.03 | $346.74 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $407.38 | Professional | None | $309.03 | $346.74 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $501.19 | Professional | None | $363.08 | $416.87 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $331.13 Typical High $478.63 | Facility | None | $245.47 | $331.13 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $537.03 | Professional | None | $398.11 | $467.74 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $467.74 | Professional | None | $371.54 | $436.52 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $977.24 | Professional | None | $436.52 | $588.84 | $977.24 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $602.56 | Professional | None | $281.84 | $389.05 | $602.56 |
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 $199.53 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $41.69 |
Where Utah sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 27th of 51
$417
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.