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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $467.74 | Professional | None | $223.87 | $363.08 | $467.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $478.63 Median $501.19 Typical High $758.58 | Facility | None | $478.63 | $501.19 | $758.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $512.86 Typical High $588.84 | Professional | None | $257.04 | $512.86 | $588.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $707.95 | Professional | None | $316.23 | $407.38 | $707.95 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $398.11 | Professional | None | $169.82 | $218.78 | $398.11 |
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 $70.79 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.79 |
Where Utah sits
The same service costs 2.2 times more in Wisconsin than in Pennsylvania. 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
$355
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.