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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $31.62 Typical High $31.62 | Professional | None | $25.70 | $31.62 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $44.67 | Professional | None | $30.20 | $44.67 | $44.67 |
Regence BlueShield Setting Professional Modifier None Typical Low $22.39 Median $23.99 Typical High $26.30 | Professional | None | $22.39 | $23.99 | $26.30 |
Select Health Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $46.77 | Professional | None | $38.02 | $45.71 | $46.77 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $44.67 | Professional | None | $24.55 | $28.84 | $44.67 |
United Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $36.31 | Professional | None | $20.89 | $25.12 | $36.31 |
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 $12.88 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $12.88 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $5.13 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $3.98 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.63 | $3.16 | $3.16 |
Where Utah sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 25th of 51
$26.30
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.