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 $117.49 Median $7,943.28 Typical High $27,542.29 | Facility | None | $117.49 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | None | $117.49 | $117.49 | $125.89 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $87.10 Median $6,456.54 Typical High $13,489.63 | Facility | None | $87.10 | $6,456.54 | $13,489.63 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $323.59 | Professional | None | $147.91 | $239.88 | $323.59 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $109.65 Typical High $2,089.30 | Facility | None | $87.10 | $109.65 | $2,089.30 |
Premera BCBS Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $158.49 | Facility | None | $144.54 | $144.54 | $158.49 |
Premera BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $12,882.50 | Facility | None | $5,128.61 | $6,760.83 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $323.59 | Professional | None | $147.91 | $239.88 | $323.59 |
United Setting Facility Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $13,803.84 | Facility | None | $6,165.95 | $8,912.51 | $13,803.84 |
United Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $371.54 | Professional | None | $134.90 | $177.83 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $190.55 | Professional | None | $123.03 | $154.88 | $190.55 |
6 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 $57.54 Median $57.54 Typical High $63.10 | Professional | 52 · Reduced service | $57.54 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $25.12 | Professional | 53 · Discontinued | $23.44 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 54 · Surgery only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.59 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,232.93 Typical High $19,498.45 | Facility | 50 · Both sides | $7,762.47 | $10,232.93 | $19,498.45 |
Where Washington sits
The same service costs 51.3 times more in Oklahoma than in Kentucky. 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· 39th of 51
$158
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.