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 $61.66 Median $4,677.35 Typical High $20,417.38 | Facility | None | $61.66 | $4,677.35 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $134.90 Typical High $251.19 | Professional | None | $52.48 | $134.90 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $37.15 | Facility | None | $30.90 | $30.90 | $37.15 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $64.57 Median $204.17 Typical High $1,071.52 | Professional | None | $64.57 | $204.17 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $141.25 Typical High $331.13 | Professional | None | $58.88 | $141.25 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $134.90 Typical High $331.13 | Professional | None | $61.66 | $134.90 | $331.13 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $257.04 | Professional | None | $81.28 | $158.49 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $223.87 Typical High $295.12 | Facility | None | $177.83 | $223.87 | $295.12 |
Premera BCBS Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $162.18 | Facility | None | $158.49 | $162.18 | $162.18 |
Premera BCBS Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $158.49 | Professional | None | $64.57 | $158.49 | $158.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $141.25 Typical High $275.42 | Professional | None | $64.57 | $141.25 | $275.42 |
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 $61.66 Median $147.91 Typical High $323.59 | Professional | None | $61.66 | $147.91 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $162.18 | Professional | None | $46.77 | $83.18 | $162.18 |
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 $30.20 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $30.20 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $25.70 Typical High $36.31 | Professional | 53 · Discontinued | $12.30 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $97.72 Typical High $134.90 | Professional | 54 · Surgery only | $45.71 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $9.12 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $12.88 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.17 | $12.88 | $18.20 |
Where Washington sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 9th of 51
$158
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.