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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $19.05 Typical High $19.05 | Professional | None | $16.22 | $19.05 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
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 $13.80 Median $14.45 Typical High $16.22 | Professional | None | $13.80 | $14.45 | $16.22 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $95.50 | Professional | None | $75.86 | $91.20 | $95.50 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $14.79 Median $17.38 Typical High $27.54 | Professional | None | $14.79 | $17.38 | $27.54 |
United Setting Professional Modifier None Typical Low $12.59 Median $14.45 Typical High $21.88 | Professional | None | $12.59 | $14.45 | $21.88 |
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 $8.32 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $8.32 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.31 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.51 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.66 | $1.91 | $1.91 |
Where Utah sits
The same service costs 4.9 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· 23rd of 51
$15.85
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.