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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $64.57 Median $125.89 Typical High $169.82 | Facility | None | $64.57 | $125.89 | $169.82 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $112.20 Median $512.86 Typical High $724.44 | Professional | None | $112.20 | $512.86 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $407.38 | Professional | None | $134.90 | $134.90 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $70.79 Typical High $79.43 | Professional | None | $30.20 | $70.79 | $79.43 |
Pacific Source Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $169.82 | Facility | None | $66.07 | $144.54 | $169.82 |
Premera BCBS Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $114.82 | Facility | None | $109.65 | $109.65 | $114.82 |
Premera BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $117.49 Median $125.89 Typical High $169.82 | Facility | None | $117.49 | $125.89 | $169.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $186.21 | Professional | None | $112.20 | $112.20 | $186.21 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $3,630.78 Typical High $37,153.52 | Facility | None | $1,122.02 | $3,630.78 | $37,153.52 |
United Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $208.93 | Professional | None | $97.72 | $117.49 | $208.93 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
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 $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where Washington sits
The same service costs 12.6 times more in California 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· 16th of 51
$115
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.