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 $151.36 Median $7,943.28 Typical High $27,542.29 | Facility | None | $151.36 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $158.49 | Professional | None | $123.03 | $151.36 | $158.49 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $87.10 Typical High $758.58 | Facility | None | $30.20 | $87.10 | $758.58 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $173.78 Median $891.25 Typical High $1,047.13 | Professional | None | $173.78 | $891.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $2,691.53 | Facility | None | $707.95 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $363.08 | Professional | None | $151.36 | $173.78 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $323.59 | Professional | None | $154.88 | $257.04 | $323.59 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $208.93 Typical High $371.54 | Professional | None | $38.02 | $208.93 | $371.54 |
Pacific Source Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $251.19 | Facility | None | $151.36 | $218.78 | $251.19 |
Premera BCBS Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Facility | None | $169.82 | $169.82 | $173.78 |
Premera BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $338.84 | Professional | None | $173.78 | $251.19 | $338.84 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $389.05 | Professional | None | $154.88 | $218.78 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $223.87 | Professional | None | $147.91 | $154.88 | $223.87 |
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 $75.86 Median $75.86 Typical High $79.43 | Professional | 52 · Reduced service | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | 53 · Discontinued | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 54 · Surgery only | $112.20 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $23.99 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.85 |
Where Washington sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 19th of 51
$214
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.