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 $5,128.61 Typical High $20,892.96 | Facility | None | $158.49 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $263.03 | Professional | None | $97.72 | $138.04 | $263.03 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $54.95 | Facility | None | $45.71 | $45.71 | $54.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $134.90 Median $812.83 Typical High $977.24 | Professional | None | $134.90 | $812.83 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $323.59 | Professional | None | $89.13 | $177.83 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $288.40 | Professional | None | $109.65 | $177.83 | $288.40 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $66.07 Typical High $131.83 | Professional | None | $35.48 | $66.07 | $131.83 |
Pacific Source Setting Facility Modifier None Typical Low $125.89 Median $213.80 Typical High $223.87 | Facility | None | $125.89 | $213.80 | $223.87 |
Premera BCBS Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
Premera BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $154.88 | Professional | None | $97.72 | $97.72 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $239.88 | Professional | None | $112.20 | $173.78 | $239.88 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $3,630.78 Typical High $37,153.52 | Facility | None | $1,122.02 | $3,630.78 | $37,153.52 |
United Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $346.74 | Professional | None | $102.33 | $186.21 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $117.49 | Professional | None | $61.66 | $61.66 | $117.49 |
4 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 $48.98 Median $50.12 Typical High $79.43 | Professional | 52 · Reduced service | $48.98 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.95 Typical High $31.62 | Professional | 53 · Discontinued | $19.50 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $23.99 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $15.85 |
Where Washington sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 22nd of 51
$170
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.