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 $39.81 Median $6,165.95 Typical High $20,892.96 | Facility | None | $39.81 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $42.66 | Professional | None | $30.20 | $39.81 | $42.66 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $19.05 Median $794.33 Typical High $1,659.59 | Facility | None | $19.05 | $794.33 | $1,659.59 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $831.76 | Professional | None | $33.88 | $43.65 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $41.69 Typical High $1,023.29 | Facility | None | $21.88 | $41.69 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $67.61 | Professional | None | $30.20 | $43.65 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $40.74 Typical High $79.43 | Professional | None | $20.42 | $40.74 | $79.43 |
Molina Setting Professional Modifier None Typical Low $1.38 Median $13.80 Typical High $21.88 | Professional | None | $1.38 | $13.80 | $21.88 |
Pacific Source Setting Facility Modifier None Typical Low $45.71 Median $61.66 Typical High $75.86 | Facility | None | $45.71 | $61.66 | $75.86 |
Premera BCBS Setting Facility Modifier None Typical Low $14.13 Median $20.42 Typical High $30.90 | Facility | None | $14.13 | $20.42 | $30.90 |
Premera BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | None | $33.88 | $33.88 | $43.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $575.44 Median $870.96 Typical High $1,659.59 | Facility | None | $575.44 | $870.96 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $66.07 | Professional | None | $33.88 | $43.65 | $66.07 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $1,230.27 | Facility | None | $134.90 | $346.74 | $1,230.27 |
United Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $75.86 | Professional | None | $31.62 | $43.65 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $21.38 Median $33.88 Typical High $47.86 | Professional | None | $21.38 | $33.88 | $47.86 |
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 $15.14 Median $16.60 Typical High $19.95 | Professional | 52 · Reduced service | $15.14 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.61 Typical High $7.94 | Professional | 53 · Discontinued | $6.03 | $6.61 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $25.12 Typical High $30.20 | Professional | 54 · Surgery only | $22.91 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.01 Typical High $6.03 | Professional | 55 · Aftercare only | $4.57 | $5.01 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.31 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.02 | $3.31 | $3.98 |
Where Washington sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 16th of 51
$43.65
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.