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 $100.00 Median $5,128.61 Typical High $20,892.96 | Facility | None | $100.00 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $100.00 | Professional | None | $32.36 | $64.57 | $100.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $190.55 | Facility | None | $18.62 | $18.62 | $190.55 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $41.69 Median $100.00 Typical High $616.60 | Professional | None | $41.69 | $100.00 | $616.60 |
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 $38.90 Median $75.86 Typical High $131.83 | Professional | None | $38.90 | $75.86 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $181.97 | Professional | None | $48.98 | $89.13 | $181.97 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $158.49 Typical High $257.04 | Professional | None | $26.92 | $158.49 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $138.04 Typical High $144.54 | Facility | None | $81.28 | $138.04 | $144.54 |
Premera BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Premera BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $97.72 | Professional | None | $41.69 | $41.69 | $97.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $144.54 | Professional | None | $41.69 | $83.18 | $144.54 |
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 $40.74 Median $87.10 Typical High $173.78 | Professional | None | $40.74 | $87.10 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $102.33 | Professional | None | $33.88 | $51.29 | $102.33 |
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 $19.50 Median $30.90 Typical High $50.12 | Professional | 52 · Reduced service | $19.50 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.30 Typical High $19.95 | Professional | 53 · Discontinued | $7.76 | $12.30 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $45.71 Typical High $74.13 | Professional | 54 · Surgery only | $29.51 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.12 Typical High $14.79 | Professional | 55 · Aftercare only | $5.89 | $9.12 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.17 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.89 | $6.17 | $10.00 |
Where Washington sits
The same service costs 3.3 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· 6th of 51
$100
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.