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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | None | $53.70 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $45.71 Median $47.86 Typical High $53.70 | Professional | None | $45.71 | $47.86 | $53.70 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $144.54 | Professional | None | $114.82 | $138.04 | $144.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $91.20 | Professional | None | $48.98 | $57.54 | $91.20 |
United Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $72.44 | Professional | None | $41.69 | $50.12 | $72.44 |
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 $26.92 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $26.92 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $10.72 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.13 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.37 | $6.31 | $6.31 |
Where Utah sits
The same service costs 4.0 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· 31st of 51
$50.12
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.