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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | None | $67.61 | $67.61 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $218.78 | Professional | None | $107.15 | $169.82 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $234.42 Typical High $354.81 | Facility | None | $223.87 | $234.42 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | None | $165.96 | $165.96 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $263.03 | Professional | None | $120.23 | $239.88 | $263.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $316.23 | Professional | None | $147.91 | $190.55 | $316.23 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $186.21 | Professional | None | $81.28 | $104.71 | $186.21 |
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 $33.88 Median $33.88 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.08 |
Where Utah sits
The same service costs 2.0 times more in Wisconsin than in Delaware. 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· 21st of 51
$166
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.