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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | None | $60.26 | $60.26 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $194.98 | Professional | None | $95.50 | $154.88 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $199.53 Median $208.93 Typical High $323.59 | Facility | None | $199.53 | $208.93 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $213.80 | Professional | None | $107.15 | $213.80 | $213.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | None | $131.83 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $169.82 | Professional | None | $74.13 | $93.33 | $169.82 |
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 $30.20 Median $30.20 Typical High $34.67 | Professional | 52 · Reduced service | $30.20 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $13.80 | Professional | 53 · Discontinued | $12.02 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.92 |
Where Utah sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 20th of 51
$145
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.