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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $83.18 | Professional | None | $64.57 | $64.57 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $190.55 | Professional | None | $91.20 | $147.91 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $309.03 | Facility | None | $190.55 | $199.53 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | None | $144.54 | $144.54 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $213.80 | Professional | None | $102.33 | $204.17 | $213.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $257.04 | Professional | None | $125.89 | $165.96 | $257.04 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $128.82 | Facility | None | $63.10 | $63.10 | $128.82 |
United Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $162.18 | Professional | None | $79.43 | $100.00 | $162.18 |
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 $32.36 Median $32.36 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $8.32 |
Where Utah sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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
$135
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.