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 $169.82 Median $3,890.45 Typical High $20,417.38 | Facility | None | $169.82 | $3,890.45 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $602.56 Typical High $977.24 | Professional | None | $154.88 | $602.56 | $977.24 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Facility | None | $91.20 | $91.20 | $109.65 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $199.53 Median $1,348.96 Typical High $4,897.79 | Professional | None | $199.53 | $1,348.96 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $436.52 Typical High $1,513.56 | Professional | None | $165.96 | $436.52 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $467.74 Typical High $1,513.56 | Professional | None | $181.97 | $467.74 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $478.63 Median $954.99 Typical High $1,513.56 | Professional | None | $478.63 | $954.99 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $208.93 Median $1,096.48 Typical High $1,122.02 | Facility | None | $208.93 | $1,096.48 | $1,122.02 |
Premera BCBS Setting Facility Modifier None Typical Low $794.33 Median $831.76 Typical High $831.76 | Facility | None | $794.33 | $831.76 | $831.76 |
Premera BCBS Setting Professional Modifier None Typical Low $186.21 Median $794.33 Typical High $794.33 | Professional | None | $186.21 | $794.33 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $1,348.96 | Professional | None | $186.21 | $446.68 | $1,348.96 |
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 $173.78 Median $512.86 Typical High $1,513.56 | Professional | None | $173.78 | $512.86 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $831.76 | Professional | None | $138.04 | $239.88 | $831.76 |
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 $85.11 Median $239.88 Typical High $436.52 | Professional | 52 · Reduced service | $85.11 | $239.88 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $95.50 Typical High $173.78 | Professional | 53 · Discontinued | $33.88 | $95.50 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $363.08 Typical High $660.69 | Professional | 54 · Surgery only | $128.82 | $363.08 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $72.44 Typical High $131.83 | Professional | 55 · Aftercare only | $25.70 | $72.44 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $47.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $16.98 | $47.86 | $87.10 |
Where Washington sits
The same service costs 3.8 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· 2nd of 51
$871
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.