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 $61.66 Median $239.88 Typical High $13,489.63 | Facility | None | $61.66 | $239.88 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $144.54 Typical High $316.23 | Professional | None | $51.29 | $144.54 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $302.00 | Professional | None | $58.88 | $74.13 | $302.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $38.02 | Facility | None | $31.62 | $31.62 | $38.02 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $72.44 Median $389.05 Typical High $1,862.09 | Professional | None | $72.44 | $389.05 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $151.36 Typical High $371.54 | Professional | None | $60.26 | $151.36 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $363.08 | Professional | None | $63.10 | $128.82 | $363.08 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $426.58 | Professional | None | $134.90 | $269.15 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $46.77 Median $295.12 Typical High $338.84 | Facility | None | $46.77 | $295.12 | $338.84 |
Premera BCBS Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $229.09 | Facility | None | $223.87 | $229.09 | $229.09 |
Premera BCBS Setting Professional Modifier None Typical Low $67.61 Median $223.87 Typical High $223.87 | Professional | None | $67.61 | $223.87 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $380.19 | Professional | None | $67.61 | $158.49 | $380.19 |
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 $63.10 Median $158.49 Typical High $407.38 | Professional | None | $63.10 | $158.49 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $229.09 | Professional | None | $48.98 | $85.11 | $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 $30.90 Median $54.95 Typical High $112.20 | Professional | 52 · Reduced service | $30.90 | $54.95 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $21.88 Typical High $45.71 | Professional | 53 · Discontinued | $12.30 | $21.88 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $83.18 Typical High $169.82 | Professional | 54 · Surgery only | $46.77 | $83.18 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $16.60 Typical High $33.88 | Professional | 55 · Aftercare only | $9.33 | $16.60 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.96 Typical High $22.39 | Professional | 56 · Pre-op care only | $6.17 | $10.96 | $22.39 |
Where Washington sits
The same service costs 3.9 times more in Alaska 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· 3rd of 51
$240
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.