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 $177.83 Median $5,128.61 Typical High $20,892.96 | Facility | None | $177.83 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $177.83 | Professional | None | $64.57 | $117.49 | $177.83 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $1,949.84 | Facility | None | $34.67 | $34.67 | $1,949.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $72.44 Median $295.12 Typical High $3,548.13 | Professional | None | $72.44 | $295.12 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $128.82 Typical High $288.40 | Professional | None | $60.26 | $128.82 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $295.12 | Professional | None | $64.57 | $125.89 | $295.12 |
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 $194.98 Median $223.87 Typical High $251.19 | Facility | None | $194.98 | $223.87 | $251.19 |
Premera BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Premera BCBS Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $173.78 | Professional | None | $69.18 | $173.78 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $295.12 | Professional | None | $67.61 | $154.88 | $295.12 |
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 $61.66 Median $141.25 Typical High $323.59 | Professional | None | $61.66 | $141.25 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $97.72 Typical High $186.21 | Professional | None | $54.95 | $97.72 | $186.21 |
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 $32.36 Median $56.23 Typical High $87.10 | Professional | 52 · Reduced service | $32.36 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $22.39 Typical High $35.48 | Professional | 53 · Discontinued | $13.18 | $22.39 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $16.98 Typical High $26.30 | Professional | 55 · Aftercare only | $9.77 | $16.98 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $11.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.46 | $11.22 | $17.78 |
Where Washington sits
The same service costs 2.7 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· 5th of 51
$191
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.