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 $11.48 Median $18.20 Typical High $42.66 | Facility | None | $11.48 | $18.20 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $22.39 Typical High $40.74 | Professional | None | $9.12 | $22.39 | $40.74 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $6.03 Median $7.24 Typical High $54.95 | Facility | None | $6.03 | $7.24 | $54.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $13.80 Median $67.61 Typical High $338.84 | Professional | None | $13.80 | $67.61 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $2,691.53 | Facility | None | $891.25 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $30.90 Typical High $72.44 | Professional | None | $11.22 | $30.90 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $107.15 | Professional | None | $28.18 | $28.18 | $107.15 |
Molina Setting Professional Modifier None Typical Low $0.50 Median $5.01 Typical High $31.62 | Professional | None | $0.50 | $5.01 | $31.62 |
Pacific Source Setting Facility Modifier None Typical Low $35.48 Median $52.48 Typical High $61.66 | Facility | None | $35.48 | $52.48 | $61.66 |
Premera BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Facility | None | $40.74 | $40.74 | $42.66 |
Premera BCBS Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $42.66 | Professional | None | $12.30 | $12.30 | $42.66 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.02 Median $27.54 Typical High $75.86 | Professional | None | $12.02 | $27.54 | $75.86 |
United Setting Facility Modifier None Typical Low $125.89 Median $295.12 Typical High $602.56 | Facility | None | $125.89 | $295.12 | $602.56 |
United Setting Professional Modifier None Typical Low $11.75 Median $30.20 Typical High $81.28 | Professional | None | $11.75 | $30.20 | $81.28 |
Wellpoint Setting Professional Modifier None Typical Low $10.72 Median $16.22 Typical High $45.71 | Professional | None | $10.72 | $16.22 | $45.71 |
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 $5.75 Median $12.88 Typical High $20.42 | Professional | 52 · Reduced service | $5.75 | $12.88 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $5.13 Typical High $8.13 | Professional | 53 · Discontinued | $2.29 | $5.13 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $19.05 Typical High $30.90 | Professional | 54 · Surgery only | $8.51 | $19.05 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $3.80 Typical High $6.17 | Professional | 55 · Aftercare only | $1.74 | $3.80 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $2.57 Typical High $4.07 | Professional | 56 · Pre-op care only | $1.12 | $2.57 | $4.07 |
Where Washington sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 13th of 51
$33.88
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.