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 $1.17 Median $1.17 Typical High $1.17 | Facility | None | $1.17 | $1.17 | $1.17 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.17 Typical High $1.17 | Professional | None | $1.02 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.52 Median $0.59 Typical High $0.59 | Professional | 52 · Reduced service | $0.52 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.24 Typical High $0.24 | Professional | 53 · Discontinued | $0.21 | $0.24 | $0.24 |
Molina Setting Professional Modifier None Typical Low $0.89 Median $1.02 Typical High $1.26 | Professional | None | $0.89 | $1.02 | $1.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
2 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 55 · Aftercare only Typical Low $0.15 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.15 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.10 | $0.12 | $0.12 |
Where Utah sits
The same service costs 1.5 times more in Alaska than in New Mexico. 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· 18th of 51
$1.05
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.