How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | None | $151.36 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $162.18 Typical High $208.93 | Facility | None | $151.36 | $162.18 | $208.93 |
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 $60.26 Median $107.15 Typical High $165.96 | Professional | None | $60.26 | $107.15 | $165.96 |
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 $120.23 Median $120.23 Typical High $154.88 | Professional | None | $120.23 | $120.23 | $154.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $269.15 | Professional | None | $95.50 | $169.82 | $269.15 |
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 $75.86 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $30.20 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $16.22 |
Where Utah sits
The same service costs 2.2 times more in Alaska than in North Carolina. 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· 45th 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.