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 $457.09 Median $11,220.18 Typical High $21,877.62 | Facility | None | $457.09 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $457.09 | Professional | None | $371.54 | $371.54 | $457.09 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $13,803.84 | Facility | None | $676.08 | $2,137.96 | $13,803.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,584.89 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,570.40 Typical High $4,786.30 | Facility | None | $707.95 | $2,570.40 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $562.34 | Professional | None | $257.04 | $263.03 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,951.21 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $75.86 | Professional | None | $44.67 | $48.98 | $75.86 |
Pacific Source Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Premera BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,949.84 Typical High $3,548.13 | Facility | None | $912.01 | $1,949.84 | $3,548.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $10,471.29 Typical High $19,952.62 | Facility | None | $6,918.31 | $10,471.29 | $19,952.62 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $13,803.84 | Facility | None | $1,513.56 | $2,570.40 | $13,803.84 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where Washington sits
The same service costs 64.6 times more in Wisconsin than in Montana. 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· 13th of 51
$1,995
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.