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 $91.20 Median $2,754.23 Typical High $20,417.38 | Facility | None | $91.20 | $2,754.23 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $389.05 | Professional | None | $79.43 | $173.78 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $363.08 | Professional | None | $102.33 | $102.33 | $363.08 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $54.95 | Facility | None | $45.71 | $45.71 | $54.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $104.71 Median $467.74 Typical High $2,630.27 | Professional | None | $104.71 | $467.74 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $190.55 Typical High $457.09 | Professional | None | $89.13 | $190.55 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $436.52 | Professional | None | $91.20 | $177.83 | $436.52 |
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 $186.21 Median $371.54 Typical High $524.81 | Facility | None | $186.21 | $371.54 | $524.81 |
Premera BCBS Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Premera BCBS Setting Professional Modifier None Typical Low $97.72 Median $269.15 Typical High $269.15 | Professional | None | $97.72 | $269.15 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $234.42 Typical High $457.09 | Professional | None | $97.72 | $234.42 | $457.09 |
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 $91.20 Median $208.93 Typical High $489.78 | Professional | None | $91.20 | $208.93 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $275.42 | Professional | None | $70.79 | $123.03 | $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 $45.71 Median $75.86 Typical High $134.90 | Professional | 52 · Reduced service | $45.71 | $75.86 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $30.90 Typical High $53.70 | Professional | 53 · Discontinued | $18.20 | $30.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $114.82 Typical High $204.17 | Professional | 54 · Surgery only | $69.18 | $114.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $22.91 Typical High $40.74 | Professional | 55 · Aftercare only | $13.80 | $22.91 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $15.14 Typical High $26.92 | Professional | 56 · Pre-op care only | $9.12 | $15.14 | $26.92 |
Where Washington sits
The same service costs 3.8 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· 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.