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 $229.09 Median $5,128.61 Typical High $20,892.96 | Facility | None | $229.09 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $245.47 | Professional | None | $89.13 | $147.91 | $245.47 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Facility | None | $47.86 | $47.86 | $57.54 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $102.33 Median $251.19 Typical High $1,819.70 | Professional | None | $102.33 | $251.19 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $436.52 | Professional | None | $93.33 | $194.98 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $181.97 Typical High $398.11 | Professional | None | $95.50 | $181.97 | $398.11 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $346.74 | Professional | None | $107.15 | $213.80 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $338.84 | Facility | None | $269.15 | $302.00 | $338.84 |
Premera BCBS Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Premera BCBS Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $223.87 | Professional | None | $102.33 | $223.87 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $389.05 | Professional | None | $102.33 | $223.87 | $389.05 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,122.02 Typical High $6,165.95 | Facility | None | $501.19 | $1,122.02 | $6,165.95 |
United Setting Professional Modifier None Typical Low $93.33 Median $199.53 Typical High $426.58 | Professional | None | $93.33 | $199.53 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $229.09 | Professional | None | $74.13 | $128.82 | $229.09 |
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 $47.86 Median $67.61 Typical High $114.82 | Professional | 52 · Reduced service | $47.86 | $67.61 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $27.54 Typical High $45.71 | Professional | 53 · Discontinued | $19.05 | $27.54 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $169.82 | Professional | 54 · Surgery only | $70.79 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $34.67 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.80 Typical High $22.91 | Professional | 56 · Pre-op care only | $9.55 | $13.80 | $22.91 |
Where Washington sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 10th of 51
$209
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.