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 $154.88 Median $4,677.35 Typical High $20,892.96 | Facility | None | $154.88 | $4,677.35 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $354.81 | Professional | None | $147.91 | $245.47 | $354.81 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $75.86 Median $2,238.72 Typical High $4,570.88 | Facility | None | $75.86 | $2,238.72 | $4,570.88 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $165.96 Median $562.34 Typical High $2,630.27 | Professional | None | $165.96 | $562.34 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $660.69 | Professional | None | $147.91 | $288.40 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $602.56 | Professional | None | $151.36 | $281.84 | $602.56 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $602.56 | Professional | None | $186.21 | $380.19 | $602.56 |
Pacific Source Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $489.78 | Facility | None | $295.12 | $489.78 | $489.78 |
Premera BCBS Setting Facility Modifier None Typical Low $346.74 Median $354.81 Typical High $354.81 | Facility | None | $346.74 | $354.81 | $354.81 |
Premera BCBS Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $346.74 | Professional | None | $162.18 | $346.74 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $4,466.84 | Facility | None | $1,778.28 | $2,344.23 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $602.56 | Professional | None | $162.18 | $346.74 | $602.56 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $4,897.79 | Facility | None | $2,137.96 | $3,019.95 | $4,897.79 |
United Setting Professional Modifier None Typical Low $151.36 Median $309.03 Typical High $645.65 | Professional | None | $151.36 | $309.03 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $354.81 | Professional | None | $117.49 | $208.93 | $354.81 |
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 $74.13 Median $117.49 Typical High $177.83 | Professional | 52 · Reduced service | $74.13 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $46.77 Typical High $70.79 | Professional | 53 · Discontinued | $29.51 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $177.83 Typical High $263.03 | Professional | 54 · Surgery only | $112.20 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $22.39 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.44 Typical High $35.48 | Professional | 56 · Pre-op care only | $14.79 | $23.44 | $35.48 |
Where Washington sits
The same service costs 3.4 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· 8th of 51
$355
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.