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 $85.11 Median $7,943.28 Typical High $27,542.29 | Facility | None | $85.11 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | None | $85.11 | $85.11 | $93.33 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $537.03 | Facility | None | $446.68 | $446.68 | $537.03 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $109.65 Median $4,073.80 Typical High $18,620.87 | Professional | None | $109.65 | $4,073.80 | $18,620.87 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $831.76 Typical High $3,801.89 | Facility | None | $707.95 | $831.76 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Pacific Source Setting Facility Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,737.80 | Facility | None | $1,047.13 | $1,479.11 | $1,737.80 |
Premera BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $112.20 | Facility | None | $107.15 | $107.15 | $112.20 |
Premera BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $2,511.89 Typical High $6,165.95 | Professional | None | $109.65 | $2,511.89 | $6,165.95 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $4,365.16 | Professional | None | $100.00 | $134.90 | $4,365.16 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $83.18 | Professional | None | $57.54 | $60.26 | $83.18 |
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 $42.66 Median $42.66 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.33 |
Where Washington sits
The same service costs 30.9 times more in California than in Idaho. 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.
Washington· 38th of 51
$200
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.