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 $21.88 Median $6,165.95 Typical High $27,542.29 | Facility | None | $21.88 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $47.86 Typical High $48.98 | Professional | None | $21.88 | $47.86 | $48.98 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $208.93 | Facility | None | $10.72 | $10.72 | $208.93 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $22.91 Median $47.86 Typical High $309.03 | Professional | None | $22.91 | $47.86 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $2,691.53 | Facility | None | $50.12 | $75.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $47.86 Typical High $67.61 | Professional | None | $20.89 | $47.86 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $50.12 Typical High $107.15 | Professional | None | $26.92 | $50.12 | $107.15 |
Molina Setting Professional Modifier None Typical Low $9.33 Median $52.48 Typical High $85.11 | Professional | None | $9.33 | $52.48 | $85.11 |
Pacific Source Setting Facility Modifier None Typical Low $45.71 Median $58.88 Typical High $93.33 | Facility | None | $45.71 | $58.88 | $93.33 |
Premera BCBS Setting Facility Modifier None Typical Low $29.51 Median $37.15 Typical High $45.71 | Facility | None | $29.51 | $37.15 | $45.71 |
Premera BCBS Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $40.74 | Professional | None | $22.39 | $22.91 | $40.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $208.93 | Facility | None | $165.96 | $165.96 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $22.91 Median $39.81 Typical High $60.26 | Professional | None | $22.91 | $39.81 | $60.26 |
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 $21.88 Median $48.98 Typical High $79.43 | Professional | None | $21.88 | $48.98 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $19.50 Median $29.51 Typical High $45.71 | Professional | None | $19.50 | $29.51 | $45.71 |
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 $10.96 Median $18.20 Typical High $24.55 | Professional | 52 · Reduced service | $10.96 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $7.41 Typical High $9.77 | Professional | 53 · Discontinued | $4.37 | $7.41 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $27.54 Typical High $36.31 | Professional | 54 · Surgery only | $16.22 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $5.50 Typical High $7.24 | Professional | 55 · Aftercare only | $3.24 | $5.50 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.72 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.19 | $3.72 | $4.90 |
Where Washington sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 8th of 51
$47.86
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.