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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $120.23 | Professional | None | $35.48 | $35.48 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $60.26 | Professional | None | $30.20 | $44.67 | $60.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $128.82 | Professional | None | $93.33 | $97.72 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $257.04 | Professional | None | $208.93 | $245.47 | $257.04 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $257.04 | Professional | None | $186.21 | $186.21 | $257.04 |
United Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $147.91 | Professional | None | $85.11 | $100.00 | $147.91 |
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 $17.78 Median $17.78 Typical High $60.26 | Professional | 52 · Reduced service | $17.78 | $17.78 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $23.99 | Professional | 53 · Discontinued | $7.08 | $7.08 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $18.20 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $12.02 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $12.02 |
Where Utah sits
The same service costs 3.3 times more in Alaska than in Wyoming. 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· 31st of 51
$97.72
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.