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 $158.49 Median $6,165.95 Typical High $20,892.96 | Facility | None | $158.49 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | None | $158.49 | $158.49 | $177.83 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $75.86 Median $4,265.80 Typical High $8,912.51 | Facility | None | $75.86 | $4,265.80 | $8,912.51 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $346.74 | Professional | None | $165.96 | $263.03 | $346.74 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $154.88 Typical High $239.88 | Professional | None | $26.30 | $154.88 | $239.88 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $245.47 | Facility | None | $165.96 | $234.42 | $245.47 |
Premera BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $165.96 | Facility | None | $162.18 | $162.18 | $165.96 |
Premera BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,951.21 Median $4,466.84 Typical High $8,511.38 | Facility | None | $2,951.21 | $4,466.84 | $8,511.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $346.74 | Professional | None | $165.96 | $263.03 | $346.74 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $9,332.54 | Facility | None | $3,981.07 | $6,025.60 | $9,332.54 |
United Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $380.19 | Professional | None | $147.91 | $186.21 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $208.93 | Professional | None | $138.04 | $144.54 | $208.93 |
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 $79.43 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $32.36 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $120.23 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $17.78 |
Where Washington sits
The same service costs 37.2 times more in Oklahoma 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· 40th of 51
$166
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.