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 $67.61 Median $4,677.35 Typical High $21,877.62 | Facility | None | $67.61 | $4,677.35 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $117.49 | Professional | None | $63.10 | $95.50 | $117.49 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $33.88 Typical High $331.13 | Facility | None | $30.20 | $33.88 | $331.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $89.13 Median $186.21 Typical High $1,071.52 | Professional | None | $89.13 | $186.21 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $2,691.53 | Facility | None | $891.25 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $208.93 | Professional | None | $64.57 | $97.72 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $204.17 | Professional | None | $81.28 | $134.90 | $204.17 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $107.15 Typical High $165.96 | Professional | None | $17.78 | $107.15 | $165.96 |
Pacific Source Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $190.55 | Facility | None | $107.15 | $158.49 | $190.55 |
Premera BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $117.49 | Facility | None | $114.82 | $114.82 | $117.49 |
Premera BCBS Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $117.49 | Professional | None | $72.44 | $72.44 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $208.93 | Professional | None | $72.44 | $117.49 | $208.93 |
United Setting Facility Modifier None Typical Low $125.89 Median $295.12 Typical High $602.56 | Facility | None | $125.89 | $295.12 | $602.56 |
United Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $239.88 | Professional | None | $72.44 | $123.03 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $125.89 | Professional | None | $61.66 | $91.20 | $125.89 |
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 $33.88 Median $48.98 Typical High $56.23 | Professional | 52 · Reduced service | $33.88 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.50 Typical High $22.39 | Professional | 53 · Discontinued | $13.49 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $72.44 Typical High $85.11 | Professional | 54 · Surgery only | $50.12 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.45 Typical High $16.98 | Professional | 55 · Aftercare only | $10.23 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.77 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.76 | $9.77 | $11.22 |
Where Washington sits
The same service costs 3.7 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· 23rd of 51
$112
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.