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 $380.19 Median $5,128.61 Typical High $20,892.96 | Facility | None | $380.19 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $218.78 Typical High $380.19 | Professional | None | $100.00 | $218.78 | $380.19 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $489.78 | Facility | None | $48.98 | $48.98 | $489.78 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $107.15 Median $467.74 Typical High $2,041.74 | Professional | None | $107.15 | $467.74 | $2,041.74 |
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 $100.00 Median $281.84 Typical High $660.69 | Professional | None | $100.00 | $281.84 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $630.96 | Professional | None | $125.89 | $229.09 | $630.96 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $398.11 Typical High $676.08 | Professional | None | $69.18 | $398.11 | $676.08 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $389.05 Typical High $549.54 | Facility | None | $117.49 | $389.05 | $549.54 |
Premera BCBS Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Facility | None | $323.59 | $363.08 | $363.08 |
Premera BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $323.59 | Professional | None | $97.72 | $97.72 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $602.56 | Professional | None | $107.15 | $218.78 | $602.56 |
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 $109.65 Median $257.04 Typical High $691.83 | Professional | None | $109.65 | $257.04 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $346.74 | Professional | None | $87.10 | $128.82 | $346.74 |
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 $50.12 Median $102.33 Typical High $190.55 | Professional | 52 · Reduced service | $50.12 | $102.33 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $40.74 Typical High $77.62 | Professional | 53 · Discontinued | $20.42 | $40.74 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $151.36 Typical High $288.40 | Professional | 54 · Surgery only | $75.86 | $151.36 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $30.20 Typical High $57.54 | Professional | 55 · Aftercare only | $15.14 | $30.20 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $20.42 Typical High $38.02 | Professional | 56 · Pre-op care only | $10.00 | $20.42 | $38.02 |
Where Washington sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 7th of 51
$363
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.