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 $89.13 Median $3,548.13 Typical High $20,417.38 | Facility | None | $89.13 | $3,548.13 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $158.49 | Professional | None | $81.28 | $102.33 | $158.49 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $1,949.84 | Facility | None | $46.77 | $46.77 | $1,949.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $97.72 Median $269.15 Typical High $3,715.35 | Professional | None | $97.72 | $269.15 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $263.03 | Professional | None | $85.11 | $123.03 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $263.03 | Professional | None | $83.18 | $151.36 | $263.03 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $257.04 | Professional | None | $81.28 | $158.49 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $229.09 | Facility | None | $181.97 | $208.93 | $229.09 |
Premera BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Premera BCBS Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $162.18 | Professional | None | $95.50 | $162.18 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $269.15 | Professional | None | $93.33 | $165.96 | $269.15 |
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 $87.10 Median $144.54 Typical High $295.12 | Professional | None | $87.10 | $144.54 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $169.82 | Professional | None | $72.44 | $128.82 | $169.82 |
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 $44.67 Median $54.95 Typical High $79.43 | Professional | 52 · Reduced service | $44.67 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $17.78 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $83.18 Typical High $117.49 | Professional | 54 · Surgery only | $67.61 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.60 Typical High $23.44 | Professional | 55 · Aftercare only | $13.49 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.91 | $10.96 | $15.85 |
Where Washington sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 10th of 51
$158
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.