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 $141.25 Median $4,677.35 Typical High $20,892.96 | Facility | None | $141.25 | $4,677.35 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $208.93 Typical High $446.68 | Professional | None | $74.13 | $208.93 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $63.10 | Facility | None | $52.48 | $52.48 | $63.10 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $120.23 Median $741.31 Typical High $2,818.38 | Professional | None | $120.23 | $741.31 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $707.95 | Professional | None | $100.00 | $245.47 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $218.78 Typical High $724.44 | Professional | None | $102.33 | $218.78 | $724.44 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $478.63 Typical High $776.25 | Professional | None | $239.88 | $478.63 | $776.25 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $588.84 Typical High $645.65 | Facility | None | $436.52 | $588.84 | $645.65 |
Premera BCBS Setting Facility Modifier None Typical Low $416.87 Median $446.68 Typical High $446.68 | Facility | None | $416.87 | $446.68 | $446.68 |
Premera BCBS Setting Professional Modifier None Typical Low $112.20 Median $398.11 Typical High $416.87 | Professional | None | $112.20 | $398.11 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $724.44 | Professional | None | $112.20 | $263.03 | $724.44 |
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 $102.33 Median $275.42 Typical High $794.33 | Professional | None | $102.33 | $275.42 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $478.63 | Professional | None | $79.43 | $141.25 | $478.63 |
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 $51.29 Median $102.33 Typical High $223.87 | Professional | 52 · Reduced service | $51.29 | $102.33 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $40.74 Typical High $89.13 | Professional | 53 · Discontinued | $20.42 | $40.74 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $154.88 Typical High $331.13 | Professional | 54 · Surgery only | $77.62 | $154.88 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $30.90 Typical High $66.07 | Professional | 55 · Aftercare only | $15.49 | $30.90 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $20.42 Typical High $44.67 | Professional | 56 · Pre-op care only | $10.23 | $20.42 | $44.67 |
Where Washington sits
The same service costs 4.2 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
$447
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.