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 $134.90 | Professional | None | $109.65 | $109.65 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $323.59 | Facility | None | $302.00 | $302.00 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $338.84 | Professional | None | $165.96 | $269.15 | $338.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $380.19 | Professional | None | $186.21 | $371.54 | $380.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $446.68 | Professional | None | $229.09 | $302.00 | $446.68 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $295.12 | Professional | None | $131.83 | $169.82 | $295.12 |
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 $67.61 | Professional | 52 · Reduced service | $54.95 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $21.88 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $13.49 |
Where Utah sits
The same service costs 3.0 times more in Iowa than in New York. 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· 25th of 51
$257
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.