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 $50.12 Median $3,548.13 Typical High $20,417.38 | Facility | None | $50.12 | $3,548.13 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $141.25 Typical High $323.59 | Professional | None | $37.15 | $141.25 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $251.19 | Professional | None | $47.86 | $58.88 | $251.19 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $28.84 | Facility | None | $23.99 | $23.99 | $28.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $58.88 Median $416.87 Typical High $1,479.11 | Professional | None | $58.88 | $416.87 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $125.89 Typical High $407.38 | Professional | None | $45.71 | $125.89 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $398.11 | Professional | None | $46.77 | $117.49 | $398.11 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $426.58 | Professional | None | $134.90 | $269.15 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $34.67 Median $234.42 Typical High $338.84 | Facility | None | $34.67 | $234.42 | $338.84 |
Premera BCBS Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $257.04 | Facility | None | $245.47 | $257.04 | $257.04 |
Premera BCBS Setting Professional Modifier None Typical Low $50.12 Median $245.47 Typical High $245.47 | Professional | None | $50.12 | $245.47 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $416.87 | Professional | None | $58.88 | $117.49 | $416.87 |
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 $47.86 Median $141.25 Typical High $446.68 | Professional | None | $47.86 | $141.25 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $251.19 | Professional | None | $37.15 | $64.57 | $251.19 |
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 $25.12 Median $64.57 Typical High $138.04 | Professional | 52 · Reduced service | $25.12 | $64.57 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $26.30 Typical High $56.23 | Professional | 53 · Discontinued | $10.00 | $26.30 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $97.72 Typical High $208.93 | Professional | 54 · Surgery only | $37.15 | $97.72 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $19.50 Typical High $41.69 | Professional | 55 · Aftercare only | $7.41 | $19.50 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $12.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $5.01 | $12.88 | $28.18 |
Where Washington sits
The same service costs 4.5 times more in Wisconsin 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· 2nd of 51
$251
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.