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 $144.54 Median $3,388.44 Typical High $20,417.38 | Facility | None | $144.54 | $3,388.44 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $467.74 | Professional | None | $144.54 | $269.15 | $467.74 |
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 $162.18 Median $562.34 Typical High $2,089.30 | Professional | None | $162.18 | $562.34 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $645.65 | Professional | None | $144.54 | $281.84 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $588.84 | Professional | None | $147.91 | $275.42 | $588.84 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $380.19 Typical High $602.56 | Professional | None | $190.55 | $380.19 | $602.56 |
Pacific Source Setting Facility Modifier None Typical Low $407.38 Median $457.09 Typical High $524.81 | Facility | None | $407.38 | $457.09 | $524.81 |
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 $158.49 Median $346.74 Typical High $346.74 | Professional | None | $158.49 | $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 $158.49 Median $346.74 Typical High $602.56 | Professional | None | $158.49 | $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 $147.91 Median $309.03 Typical High $645.65 | Professional | None | $147.91 | $309.03 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $354.81 | Professional | None | $117.49 | $204.17 | $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 $72.44 Median $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $72.44 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $46.77 Typical High $69.18 | Professional | 53 · Discontinued | $29.51 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $109.65 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $21.88 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.44 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.45 | $23.44 | $34.67 |
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.