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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $239.88 | Professional | None | $117.49 | $190.55 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $389.05 | Facility | None | $245.47 | $257.04 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $263.03 | Professional | None | $131.83 | $263.03 | $263.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $316.23 | Professional | None | $162.18 | $208.93 | $316.23 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $128.82 | Facility | None | $104.71 | $104.71 | $128.82 |
United Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $208.93 | Professional | None | $100.00 | $128.82 | $208.93 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where Utah sits
The same service costs 2.8 times more in Minnesota 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· 35th of 51
$162
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.