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 $524.81 Median $5,128.61 Typical High $20,892.96 | Facility | None | $524.81 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $512.86 Typical High $831.76 | Professional | None | $194.98 | $512.86 | $831.76 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Facility | None | $100.00 | $100.00 | $120.23 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $218.78 Median $1,258.93 Typical High $4,466.84 | Professional | None | $218.78 | $1,258.93 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $457.09 Typical High $1,380.38 | Professional | None | $186.21 | $457.09 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $1,318.26 | Professional | None | $194.98 | $436.52 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $831.76 Typical High $1,348.96 | Professional | None | $416.87 | $831.76 | $1,348.96 |
Pacific Source Setting Facility Modifier None Typical Low $281.84 Median $954.99 Typical High $1,023.29 | Facility | None | $281.84 | $954.99 | $1,023.29 |
Premera BCBS Setting Facility Modifier None Typical Low $724.44 Median $758.58 Typical High $758.58 | Facility | None | $724.44 | $758.58 | $758.58 |
Premera BCBS Setting Professional Modifier None Typical Low $204.17 Median $724.44 Typical High $724.44 | Professional | None | $204.17 | $724.44 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $478.63 Typical High $1,258.93 | Professional | None | $208.93 | $478.63 | $1,258.93 |
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 $190.55 Median $512.86 Typical High $1,348.96 | Professional | None | $190.55 | $512.86 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $758.58 | Professional | None | $151.36 | $263.03 | $758.58 |
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 $95.50 Median $229.09 Typical High $416.87 | Professional | 52 · Reduced service | $95.50 | $229.09 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $91.20 Typical High $169.82 | Professional | 53 · Discontinued | $38.90 | $91.20 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $338.84 Typical High $630.96 | Professional | 54 · Surgery only | $144.54 | $338.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $67.61 Typical High $125.89 | Professional | 55 · Aftercare only | $28.84 | $67.61 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $45.71 Typical High $83.18 | Professional | 56 · Pre-op care only | $19.50 | $45.71 | $83.18 |
Where Washington sits
The same service costs 3.5 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· 3rd of 51
$776
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.