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 $229.09 Median $7,943.28 Typical High $27,542.29 | Facility | None | $229.09 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | None | $229.09 | $229.09 | $239.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $1,122.02 | Facility | None | $128.82 | $128.82 | $1,122.02 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $251.19 Median $1,258.93 Typical High $1,479.11 | Professional | None | $251.19 | $1,258.93 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $776.25 Typical High $2,137.96 | Facility | None | $707.95 | $776.25 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $501.19 | Professional | None | $218.78 | $245.47 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $512.86 | Professional | None | $281.84 | $380.19 | $512.86 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $257.04 Typical High $389.05 | Professional | None | $42.66 | $257.04 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $363.08 | Facility | None | $251.19 | $338.84 | $363.08 |
Premera BCBS Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Premera BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $512.86 | Professional | None | $251.19 | $354.81 | $512.86 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $562.34 | Professional | None | $229.09 | $323.59 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $338.84 | Professional | None | $223.87 | $234.42 | $338.84 |
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 $114.82 Median $114.82 Typical High $117.49 | Professional | 52 · Reduced service | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 54 · Surgery only | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.99 |
Where Washington sits
The same service costs 4.3 times more in Wisconsin than in New York. 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· 42nd of 51
$263
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.