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 $489.78 Median $5,128.61 Typical High $20,892.96 | Facility | None | $489.78 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $489.78 | Professional | None | $204.17 | $338.84 | $489.78 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $128.82 | Facility | None | $107.15 | $107.15 | $128.82 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $229.09 Median $831.76 Typical High $3,162.28 | Professional | None | $229.09 | $831.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $891.25 | Professional | None | $204.17 | $389.05 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $851.14 | Professional | None | $213.80 | $389.05 | $851.14 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $588.84 Typical High $933.25 | Professional | None | $295.12 | $588.84 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $389.05 Median $660.69 Typical High $691.83 | Facility | None | $389.05 | $660.69 | $691.83 |
Premera BCBS Setting Facility Modifier None Typical Low $467.74 Median $489.78 Typical High $489.78 | Facility | None | $467.74 | $489.78 | $489.78 |
Premera BCBS Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $467.74 | Professional | None | $213.80 | $467.74 | $467.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $467.74 Typical High $812.83 | Professional | None | $218.78 | $467.74 | $812.83 |
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 $204.17 Median $426.58 Typical High $891.25 | Professional | None | $204.17 | $426.58 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $537.03 | Professional | None | $165.96 | $295.12 | $537.03 |
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 $102.33 Median $158.49 Typical High $245.47 | Professional | 52 · Reduced service | $102.33 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $100.00 | Professional | 53 · Discontinued | $40.74 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $371.54 | Professional | 54 · Surgery only | $151.36 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $74.13 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $48.98 |
Where Washington sits
The same service costs 3.3 times more in Alaska than in Virginia. 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
$525
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.