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 $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | None | $2.75 | $2.88 | $2.88 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $151.36 Typical High $158.49 | Facility | None | $13.49 | $151.36 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $123.03 Median $131.83 Typical High $151.36 | Professional | None | $123.03 | $131.83 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $151.36 | Professional | None | $117.49 | $120.23 | $151.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $83.18 Median $169.82 Typical High $295.12 | Professional | None | $83.18 | $169.82 | $295.12 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $1.38 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.38 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.55 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.41 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.27 | $0.28 | $0.28 |
Where Utah sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 16th of 51
$126
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.