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 $302.00 Median $5,128.61 Typical High $20,892.96 | Facility | None | $302.00 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $144.54 Typical High $302.00 | Professional | None | $57.54 | $144.54 | $302.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $34.67 | Facility | None | $28.84 | $28.84 | $34.67 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $64.57 Median $512.86 Typical High $1,949.84 | Professional | None | $64.57 | $512.86 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $162.18 Typical High $478.63 | Professional | None | $57.54 | $162.18 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $131.83 Typical High $478.63 | Professional | None | $56.23 | $131.83 | $478.63 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $602.56 | Professional | None | $186.21 | $371.54 | $602.56 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $407.38 Typical High $426.58 | Facility | None | $141.25 | $407.38 | $426.58 |
Premera BCBS Setting Facility Modifier None Typical Low $288.40 Median $302.00 Typical High $302.00 | Facility | None | $288.40 | $302.00 | $302.00 |
Premera BCBS Setting Professional Modifier None Typical Low $60.26 Median $281.84 Typical High $288.40 | Professional | None | $60.26 | $281.84 | $288.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $501.19 | Professional | None | $61.66 | $141.25 | $501.19 |
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 $56.23 Median $162.18 Typical High $537.03 | Professional | None | $56.23 | $162.18 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $323.59 | Professional | None | $44.67 | $77.62 | $323.59 |
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 $28.84 Median $61.66 Typical High $151.36 | Professional | 52 · Reduced service | $28.84 | $61.66 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $25.12 Typical High $60.26 | Professional | 53 · Discontinued | $11.48 | $25.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $93.33 Typical High $223.87 | Professional | 54 · Surgery only | $43.65 | $93.33 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $18.62 Typical High $44.67 | Professional | 55 · Aftercare only | $8.71 | $18.62 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $12.59 Typical High $30.20 | Professional | 56 · Pre-op care only | $5.75 | $12.59 | $30.20 |
Where Washington sits
The same service costs 5.8 times more in Washington than in Virginia. 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· 1st of 51
$331
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.