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 $83.18 Median $3,548.13 Typical High $20,417.38 | Facility | None | $83.18 | $3,548.13 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $338.84 | Professional | None | $64.57 | $158.49 | $338.84 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $50.12 | Facility | None | $41.69 | $41.69 | $50.12 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $95.50 Median $457.09 Typical High $2,818.38 | Professional | None | $95.50 | $457.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $436.52 | Professional | None | $81.28 | $186.21 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $426.58 | Professional | None | $85.11 | $165.96 | $426.58 |
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 $302.00 Median $371.54 Typical High $537.03 | Facility | None | $302.00 | $371.54 | $537.03 |
Premera BCBS Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $263.03 | Facility | None | $257.04 | $263.03 | $263.03 |
Premera BCBS Setting Professional Modifier None Typical Low $89.13 Median $257.04 Typical High $257.04 | Professional | None | $89.13 | $257.04 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $213.80 Typical High $446.68 | Professional | None | $89.13 | $213.80 | $446.68 |
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 $83.18 Median $194.98 Typical High $478.63 | Professional | None | $83.18 | $194.98 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $275.42 | Professional | None | $64.57 | $112.20 | $275.42 |
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 $41.69 Median $69.18 Typical High $131.83 | Professional | 52 · Reduced service | $41.69 | $69.18 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $27.54 Typical High $52.48 | Professional | 53 · Discontinued | $16.60 | $27.54 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $104.71 Typical High $199.53 | Professional | 54 · Surgery only | $63.10 | $104.71 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $20.89 Typical High $39.81 | Professional | 55 · Aftercare only | $12.59 | $20.89 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.80 Typical High $26.30 | Professional | 56 · Pre-op care only | $8.32 | $13.80 | $26.30 |
Where Washington sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 5th of 51
$257
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.