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 $323.59 Median $7,943.28 Typical High $27,542.29 | Facility | None | $323.59 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $354.81 | Professional | None | $257.04 | $323.59 | $354.81 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $162.18 Typical High $1,479.11 | Facility | None | $30.20 | $162.18 | $1,479.11 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $4,365.16 | Professional | None | $389.05 | $602.56 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $2,691.53 | Facility | None | $707.95 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $602.56 | Professional | None | $281.84 | $288.40 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $602.56 | Professional | None | $218.78 | $363.08 | $602.56 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $489.78 | Professional | None | $154.88 | $281.84 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $346.74 Median $446.68 Typical High $478.63 | Facility | None | $346.74 | $446.68 | $478.63 |
Premera BCBS Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Facility | None | $323.59 | $323.59 | $331.13 |
Premera BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | None | $389.05 | $389.05 | $549.54 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $630.96 | Professional | None | $281.84 | $346.74 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $426.58 | Professional | None | $213.80 | $288.40 | $426.58 |
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 $125.89 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $125.89 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $51.29 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $190.55 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $38.02 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $32.36 |
Where Washington sits
The same service costs 5.0 times more in Alaska 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· 26th of 51
$316
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.