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 $234.42 Median $5,128.61 Typical High $20,892.96 | Facility | None | $234.42 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $234.42 | Professional | None | $186.21 | $223.87 | $234.42 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $95.50 Median $2,137.96 Typical High $4,466.84 | Facility | None | $95.50 | $2,137.96 | $4,466.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $1,584.89 | Professional | None | $208.93 | $398.11 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $234.42 Typical High $630.96 | Facility | None | $123.03 | $234.42 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $457.09 | Professional | None | $169.82 | $234.42 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $275.42 Typical High $426.58 | Professional | None | $128.82 | $275.42 | $426.58 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $338.84 Typical High $588.84 | Professional | None | $57.54 | $338.84 | $588.84 |
Premera BCBS Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $169.82 | Facility | None | $75.86 | $97.72 | $169.82 |
Premera BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | None | $194.98 | $194.98 | $245.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $4,466.84 | Facility | None | $1,548.82 | $2,344.23 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $436.52 | Professional | None | $190.55 | $295.12 | $436.52 |
United Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $3,630.78 | Facility | None | $371.54 | $691.83 | $3,630.78 |
United Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $478.63 | Professional | None | $181.97 | $269.15 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $263.03 | Professional | None | $173.78 | $257.04 | $263.03 |
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 $93.33 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $93.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $37.15 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $154.88 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $23.44 |
Where Washington sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 9th of 51
$309
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.