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 $64.57 Median $6,165.95 Typical High $20,892.96 | Facility | None | $64.57 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $67.61 | Professional | None | $60.26 | $64.57 | $67.61 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $31.62 Median $1,174.90 Typical High $2,398.83 | Facility | None | $31.62 | $1,174.90 | $2,398.83 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $501.19 | Professional | None | $69.18 | $123.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $691.83 | Facility | None | $331.13 | $467.74 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $128.82 | Professional | None | $60.26 | $60.26 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $107.15 Typical High $467.74 | Professional | None | $47.86 | $107.15 | $467.74 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $50.12 Typical High $85.11 | Professional | None | $26.92 | $50.12 | $85.11 |
Pacific Source Setting Facility Modifier None Typical Low $61.66 Median $95.50 Typical High $102.33 | Facility | None | $61.66 | $95.50 | $102.33 |
Premera BCBS Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $407.38 | Facility | None | $138.04 | $245.47 | $407.38 |
Premera BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $851.14 Median $1,258.93 Typical High $2,398.83 | Facility | None | $851.14 | $1,258.93 | $2,398.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $112.20 | Professional | None | $69.18 | $69.18 | $112.20 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $1,778.28 | Facility | None | $134.90 | $346.74 | $1,778.28 |
United Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $131.83 | Professional | None | $58.88 | $72.44 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $85.11 | Professional | None | $42.66 | $57.54 | $85.11 |
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 $32.36 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.88 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | 54 · Surgery only | $45.71 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $9.55 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.46 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.46 | $6.61 |
Where Washington sits
The same service costs 4.2 times more in Alaska 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· 33rd 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.