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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $91.20 | Professional | None | $31.62 | $31.62 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $45.71 | Professional | 52 · Reduced service | $15.85 | $15.85 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $18.62 | Professional | 53 · Discontinued | $6.31 | $6.31 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $13.80 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $93.33 | Professional | None | $60.26 | $83.18 | $93.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $102.33 Typical High $154.88 | Facility | None | $97.72 | $102.33 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $125.89 | Professional | None | $83.18 | $104.71 | $125.89 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $154.88 | Professional | None | $79.43 | $104.71 | $154.88 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $69.18 | Professional | None | $43.65 | $48.98 | $69.18 |
3 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Utah sits
The same service costs 2.6 times more in Hawaii 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· 49th of 51
$47.86
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.