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 $87.10 Median $4,265.80 Typical High $20,892.96 | Facility | None | $87.10 | $4,265.80 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $269.15 | Professional | None | $85.11 | $190.55 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $181.97 | Professional | None | $64.57 | $123.03 | $181.97 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $56.23 | Facility | None | $46.77 | $46.77 | $56.23 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $95.50 Median $457.09 Typical High $1,479.11 | Professional | None | $95.50 | $457.09 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $380.19 | Professional | None | $87.10 | $204.17 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $426.58 | Professional | None | $81.28 | $181.97 | $426.58 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $354.81 | Professional | None | $107.15 | $204.17 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $281.84 Median $302.00 Typical High $363.08 | Facility | None | $281.84 | $302.00 | $363.08 |
Premera BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Facility | None | $229.09 | $229.09 | $234.42 |
Premera BCBS Setting Professional Modifier None Typical Low $93.33 Median $234.42 Typical High $234.42 | Professional | None | $93.33 | $234.42 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $380.19 | Professional | None | $95.50 | $204.17 | $380.19 |
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 $93.33 Median $213.80 Typical High $436.52 | Professional | None | $93.33 | $213.80 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $371.54 | Professional | None | $64.57 | $123.03 | $371.54 |
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 $43.65 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $43.65 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $17.38 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $66.07 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $13.18 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $8.71 | $20.89 | $25.12 |
Where Washington sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 11th of 51
$214
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.