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 $56.23 Median $309.03 Typical High $20,417.38 | Facility | None | $56.23 | $309.03 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $204.17 Typical High $407.38 | Professional | None | $47.86 | $204.17 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $64.57 | Professional | None | $61.66 | $63.10 | $64.57 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $1,949.84 | Facility | None | $28.18 | $28.18 | $1,949.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $58.88 Median $323.59 Typical High $2,238.72 | Professional | None | $58.88 | $323.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $158.49 Typical High $524.81 | Professional | None | $53.70 | $158.49 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $144.54 Typical High $478.63 | Professional | None | $54.95 | $144.54 | $478.63 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $323.59 Typical High $512.86 | Professional | None | $158.49 | $323.59 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $436.52 | Facility | None | $331.13 | $389.05 | $436.52 |
Premera BCBS Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $295.12 | Facility | None | $288.40 | $295.12 | $295.12 |
Premera BCBS Setting Professional Modifier None Typical Low $58.88 Median $288.40 Typical High $288.40 | Professional | None | $58.88 | $288.40 | $288.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $58.88 Median $138.04 Typical High $478.63 | Professional | None | $58.88 | $138.04 | $478.63 |
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 $54.95 Median $177.83 Typical High $524.81 | Professional | None | $54.95 | $177.83 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $302.00 | Professional | None | $42.66 | $75.86 | $302.00 |
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 $27.54 Median $81.28 Typical High $154.88 | Professional | 52 · Reduced service | $27.54 | $81.28 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $32.36 Typical High $61.66 | Professional | 53 · Discontinued | $11.22 | $32.36 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $24.55 Typical High $46.77 | Professional | 55 · Aftercare only | $8.32 | $24.55 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $16.22 Typical High $30.90 | Professional | 56 · Pre-op care only | $5.62 | $16.22 | $30.90 |
Where Washington sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 3rd of 51
$295
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.