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 $63.10 Median $1,445.44 Typical High $17,378.01 | Facility | None | $63.10 | $1,445.44 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $104.71 | Professional | None | $44.67 | $64.57 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $125.89 | Professional | None | $67.61 | $97.72 | $125.89 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $309.03 | Facility | None | $32.36 | $32.36 | $309.03 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $512.86 | Professional | None | $72.44 | $134.90 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $741.31 Typical High $2,137.96 | Facility | None | $707.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $158.49 | Professional | None | $58.88 | $77.62 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $144.54 | Professional | None | $64.57 | $114.82 | $144.54 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $112.20 Typical High $194.98 | Professional | None | $19.50 | $112.20 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $120.23 | Facility | None | $72.44 | $114.82 | $120.23 |
Premera BCBS Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Facility | None | $81.28 | $81.28 | $83.18 |
Premera BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | None | $67.61 | $67.61 | $83.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $147.91 | Professional | None | $67.61 | $104.71 | $147.91 |
United Setting Facility Modifier None Typical Low $125.89 Median $295.12 Typical High $602.56 | Facility | None | $125.89 | $295.12 | $602.56 |
United Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $165.96 | Professional | None | $64.57 | $93.33 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $87.10 | Professional | None | $57.54 | $83.18 | $87.10 |
5 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 $31.62 Median $34.67 Typical High $38.90 | Professional | 52 · Reduced service | $31.62 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.80 Typical High $15.49 | Professional | 53 · Discontinued | $12.59 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $52.48 Typical High $57.54 | Professional | 54 · Surgery only | $46.77 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $9.33 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.92 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.31 | $6.92 | $7.76 |
Where Washington sits
The same service costs 4.8 times more in Alaska 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· 9th of 51
$105
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.