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 $229.09 Median $1,096.48 Typical High $1,905.46 | Professional | None | $229.09 | $1,096.48 | $1,905.46 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $346.74 Median $2,754.23 Typical High $13,489.63 | Professional | None | $346.74 | $2,754.23 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $794.33 Typical High $3,548.13 | Professional | None | $288.40 | $794.33 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $758.58 Typical High $3,162.28 | Professional | None | $295.12 | $758.58 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,202.26 | $2,454.71 | $3,981.07 |
Pacific Source Setting Facility Modifier None Typical Low $223.87 Median $2,238.72 Typical High $2,511.89 | Facility | None | $223.87 | $2,238.72 | $2,511.89 |
Premera BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,737.80 | $1,737.80 | $1,778.28 |
Premera BCBS Setting Professional Modifier None Typical Low $338.84 Median $1,778.28 Typical High $1,778.28 | Professional | None | $338.84 | $1,778.28 | $1,778.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $812.83 Typical High $3,090.30 | Professional | None | $331.13 | $812.83 | $3,090.30 |
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 $302.00 Median $1,174.90 Typical High $3,311.31 | Professional | None | $302.00 | $1,174.90 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $2,238.72 | Professional | None | $251.19 | $436.52 | $2,238.72 |
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 $151.36 Median $549.54 Typical High $954.99 | Professional | 52 · Reduced service | $151.36 | $549.54 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $218.78 Typical High $380.19 | Professional | 53 · Discontinued | $60.26 | $218.78 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $812.83 Typical High $1,445.44 | Professional | 54 · Surgery only | $223.87 | $812.83 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $162.18 Typical High $288.40 | Professional | 55 · Aftercare only | $44.67 | $162.18 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $109.65 Typical High $190.55 | Professional | 56 · Pre-op care only | $30.20 | $109.65 | $190.55 |
Where Washington sits
The same service costs 6.5 times more in Washington 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· 1st of 51
$2,138
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.