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 $234.42 Median $5,128.61 Typical High $20,892.96 | Facility | None | $234.42 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $234.42 | Professional | None | $83.18 | $144.54 | $234.42 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $46.77 | Facility | None | $38.90 | $38.90 | $46.77 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $95.50 Median $354.81 Typical High $3,090.30 | Professional | None | $95.50 | $354.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $389.05 | Professional | None | $75.86 | $162.18 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $346.74 | Professional | None | $77.62 | $151.36 | $346.74 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $346.74 | Professional | None | $107.15 | $213.80 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $323.59 | Facility | None | $245.47 | $269.15 | $323.59 |
Premera BCBS Setting Facility Modifier None Typical Low $208.93 Median $213.80 Typical High $213.80 | Facility | None | $208.93 | $213.80 | $213.80 |
Premera BCBS Setting Professional Modifier None Typical Low $83.18 Median $208.93 Typical High $208.93 | Professional | None | $83.18 | $208.93 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $354.81 | Professional | None | $95.50 | $186.21 | $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 $79.43 Median $177.83 Typical High $398.11 | Professional | None | $79.43 | $177.83 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $213.80 | Professional | None | $60.26 | $104.71 | $213.80 |
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 $41.69 Median $69.18 Typical High $117.49 | Professional | 52 · Reduced service | $41.69 | $69.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $27.54 Typical High $46.77 | Professional | 53 · Discontinued | $16.60 | $27.54 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $104.71 Typical High $177.83 | Professional | 54 · Surgery only | $61.66 | $104.71 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $20.89 Typical High $35.48 | Professional | 55 · Aftercare only | $12.30 | $20.89 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.80 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.32 | $13.80 | $23.44 |
Where Washington sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 6th of 51
$209
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.