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 $288.40 Median $7,943.28 Typical High $27,542.29 | Facility | None | $288.40 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $323.59 | Professional | None | $245.47 | $288.40 | $323.59 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $1,412.54 | Facility | None | $162.18 | $162.18 | $1,412.54 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $316.23 Median $1,621.81 Typical High $1,905.46 | Professional | None | $316.23 | $1,621.81 | $1,905.46 |
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 $281.84 Median $309.03 Typical High $645.65 | Professional | None | $281.84 | $309.03 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $645.65 | Professional | None | $354.81 | $478.63 | $645.65 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $309.03 Typical High $467.74 | Professional | None | $51.29 | $309.03 | $467.74 |
Pacific Source Setting Facility Modifier None Typical Low $316.23 Median $436.52 Typical High $467.74 | Facility | None | $316.23 | $436.52 | $467.74 |
Premera BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Premera BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $645.65 | Professional | None | $316.23 | $446.68 | $645.65 |
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 $295.12 Median $407.38 Typical High $707.95 | Professional | None | $295.12 | $407.38 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $426.58 | Professional | None | $288.40 | $295.12 | $426.58 |
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 $144.54 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 54 · Surgery only | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $30.20 |
Where Washington sits
The same service costs 4.0 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
$316
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.