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 $28.18 Median $6,165.95 Typical High $20,892.96 | Facility | None | $28.18 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $46.77 | Professional | None | $28.18 | $28.18 | $46.77 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $40.74 Median $724.44 Typical High $1,412.54 | Facility | None | $40.74 | $724.44 | $1,412.54 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $29.51 Median $165.96 Typical High $467.74 | Professional | None | $29.51 | $165.96 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $1,000.00 | Facility | None | $186.21 | $354.81 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $151.36 | Professional | None | $60.26 | $107.15 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $104.71 Typical High $269.15 | Professional | None | $39.81 | $104.71 | $269.15 |
Pacific Source Setting Facility Modifier None Typical Low $30.20 Median $51.29 Typical High $53.70 | Facility | None | $30.20 | $51.29 | $53.70 |
Premera BCBS Setting Facility Modifier None Typical Low $117.49 Median $154.88 Typical High $251.19 | Facility | None | $117.49 | $154.88 | $251.19 |
Premera BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $1,380.38 | Facility | None | $562.34 | $741.31 | $1,380.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $29.51 Median $100.00 Typical High $151.36 | Professional | None | $29.51 | $100.00 | $151.36 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $1,023.29 | Facility | None | $134.90 | $346.74 | $1,023.29 |
United Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $173.78 | Professional | None | $27.54 | $41.69 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $81.28 | Professional | None | $53.70 | $74.13 | $81.28 |
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 $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 54 · Surgery only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where Washington sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 16th of 51
$117
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.