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 $57.54 Median $6,165.95 Typical High $20,892.96 | Facility | None | $57.54 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $34.67 Median $338.84 Typical High $707.95 | Facility | None | $34.67 | $338.84 | $707.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $64.57 Median $120.23 Typical High $512.86 | Professional | None | $64.57 | $120.23 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $75.86 | Facility | None | $50.12 | $52.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $138.04 | Professional | None | $54.95 | $61.66 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $128.82 | Professional | None | $69.18 | $97.72 | $128.82 |
Molina Setting Professional Modifier None Typical Low $8.91 Median $53.70 Typical High $81.28 | Professional | None | $8.91 | $53.70 | $81.28 |
Pacific Source Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $102.33 | Facility | None | $69.18 | $89.13 | $102.33 |
Premera BCBS Setting Facility Modifier None Typical Low $8.51 Median $11.48 Typical High $63.10 | Facility | None | $8.51 | $11.48 | $63.10 |
Premera BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $371.54 Typical High $707.95 | Facility | None | $245.47 | $371.54 | $707.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $131.83 | Professional | None | $64.57 | $93.33 | $131.83 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $616.60 | Facility | None | $134.90 | $346.74 | $616.60 |
United Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $144.54 | Professional | None | $58.88 | $81.28 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $91.20 | Professional | None | $60.26 | $63.10 | $91.20 |
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 $28.84 Median $28.84 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 54 · Surgery only | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.17 |
Where Washington sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 42nd of 51
$64.57
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.