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 $165.96 Median $6,165.95 Typical High $20,892.96 | Facility | None | $165.96 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $186.21 | Professional | None | $131.83 | $165.96 | $186.21 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $97.72 | Facility | None | $81.28 | $81.28 | $97.72 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $1,862.09 | Professional | None | $177.83 | $363.08 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $354.81 | Professional | None | $158.49 | $208.93 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $338.84 | Professional | None | $125.89 | $251.19 | $338.84 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $257.04 | Professional | None | $85.11 | $162.18 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $257.04 | Facility | None | $208.93 | $245.47 | $257.04 |
Premera BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Premera BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $354.81 | Professional | None | $177.83 | $245.47 | $354.81 |
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 $138.04 Median $199.53 Typical High $398.11 | Professional | None | $138.04 | $199.53 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $218.78 | Professional | None | $109.65 | $147.91 | $218.78 |
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 $64.57 Median $83.18 Typical High $93.33 | Professional | 52 · Reduced service | $64.57 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $26.30 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $125.89 Typical High $138.04 | Professional | 54 · Surgery only | $97.72 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.12 Typical High $28.18 | Professional | 55 · Aftercare only | $19.50 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.18 | $16.60 | $18.62 |
Where Washington sits
The same service costs 3.7 times more in Alaska 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· 30th of 51
$174
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.