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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $97.72 | Professional | None | $85.11 | $89.13 | $97.72 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $74.13 Median $977.24 Typical High $2,041.74 | Facility | None | $74.13 | $977.24 | $2,041.74 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $112.20 Median $524.81 Typical High $851.14 | Professional | None | $112.20 | $524.81 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | None | $70.79 | $70.79 | $75.86 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $186.21 | Facility | None | $112.20 | $165.96 | $186.21 |
Premera BCBS Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $128.82 | Facility | None | $117.49 | $117.49 | $128.82 |
Premera BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,041.74 | Facility | None | $812.83 | $1,071.52 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $251.19 | Professional | None | $112.20 | $158.49 | $251.19 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,041.74 | Facility | None | $1,000.00 | $1,318.26 | $2,041.74 |
United Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $229.09 | Professional | None | $87.10 | $100.00 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $19.50 | Professional | 53 · Discontinued | $16.98 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $9.55 |
Where Washington sits
The same service costs 5.0 times more in Alaska than in Pennsylvania. 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· 13th of 51
$132
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.