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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | None | $100.00 | $100.00 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
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 $120.23 Median $120.23 Typical High $151.36 | Professional | None | $120.23 | $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 $50.12 Median $50.12 Typical High $54.95 | Professional | 52 · Reduced service | $50.12 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | 53 · Discontinued | $19.95 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $16.60 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.96 |
Where Utah sits
The same service costs 2.3 times more in North Dakota 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· 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.