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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | None | $109.65 | $109.65 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $323.59 | Professional | None | $151.36 | $245.47 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $338.84 Typical High $512.86 | Facility | None | $323.59 | $338.84 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | None | $239.88 | $239.88 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $380.19 | Professional | None | $173.78 | $346.74 | $380.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $457.09 | Professional | None | $213.80 | $275.42 | $457.09 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
United Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $269.15 | Professional | None | $131.83 | $169.82 | $269.15 |
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 $54.95 Median $54.95 Typical High $56.23 | Professional | 52 · Reduced service | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $22.39 | Professional | 53 · Discontinued | $21.88 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $11.22 |
Where Utah sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 24th of 51
$240
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.