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 $691.83 Median $6,165.95 Typical High $20,892.96 | Facility | None | $691.83 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $588.84 Typical High $831.76 | Professional | None | $154.88 | $588.84 | $831.76 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Facility | None | $79.43 | $79.43 | $95.50 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $177.83 Median $1,288.25 Typical High $4,677.35 | Professional | None | $177.83 | $1,288.25 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $478.63 Typical High $1,380.38 | Professional | None | $147.91 | $478.63 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $398.11 Typical High $1,348.96 | Professional | None | $154.88 | $398.11 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $851.14 Typical High $1,380.38 | Professional | None | $426.58 | $851.14 | $1,380.38 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $977.24 Typical High $1,174.90 | Facility | None | $891.25 | $977.24 | $1,174.90 |
Premera BCBS Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $776.25 | Facility | None | $741.31 | $776.25 | $776.25 |
Premera BCBS Setting Professional Modifier None Typical Low $165.96 Median $741.31 Typical High $741.31 | Professional | None | $165.96 | $741.31 | $741.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $1,288.25 | Professional | None | $165.96 | $389.05 | $1,288.25 |
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 $154.88 Median $467.74 Typical High $1,380.38 | Professional | None | $154.88 | $467.74 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $794.33 | Professional | None | $120.23 | $213.80 | $794.33 |
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 $77.62 Median $208.93 Typical High $407.38 | Professional | 52 · Reduced service | $77.62 | $208.93 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $83.18 Typical High $165.96 | Professional | 53 · Discontinued | $30.90 | $83.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $309.03 Typical High $616.60 | Professional | 54 · Surgery only | $114.82 | $309.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $61.66 Typical High $123.03 | Professional | 55 · Aftercare only | $22.91 | $61.66 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $41.69 Typical High $81.28 | Professional | 56 · Pre-op care only | $15.49 | $41.69 | $81.28 |
Where Washington sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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· 2nd of 51
$794
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.