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 $31.62 Median $6,165.95 Typical High $27,542.29 | Facility | None | $31.62 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $56.23 | Professional | None | $31.62 | $33.88 | $56.23 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $14.13 Median $338.84 Typical High $707.95 | Facility | None | $14.13 | $338.84 | $707.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $25.70 Median $64.57 Typical High $660.69 | Professional | None | $25.70 | $64.57 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $75.86 | Facility | None | $50.12 | $52.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $60.26 | Professional | None | $38.90 | $47.86 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $100.00 | Professional | None | $38.90 | $60.26 | $100.00 |
Molina Setting Professional Modifier None Typical Low $1.41 Median $12.30 Typical High $19.05 | Professional | None | $1.41 | $12.30 | $19.05 |
Pacific Source Setting Facility Modifier None Typical Low $30.90 Median $37.15 Typical High $100.00 | Facility | None | $30.90 | $37.15 | $100.00 |
Premera BCBS Setting Facility Modifier None Typical Low $17.38 Median $23.44 Typical High $26.92 | Facility | None | $17.38 | $23.44 | $26.92 |
Premera BCBS Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | None | $25.70 | $30.20 | $30.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $371.54 Typical High $707.95 | Facility | None | $245.47 | $371.54 | $707.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $48.98 | Professional | None | $25.70 | $29.51 | $48.98 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $616.60 | Facility | None | $134.90 | $346.74 | $616.60 |
United Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $67.61 | Professional | None | $33.88 | $40.74 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $12.88 Median $22.39 Typical High $27.54 | Professional | None | $12.88 | $22.39 | $27.54 |
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 $15.85 Median $16.22 Typical High $16.98 | Professional | 52 · Reduced service | $15.85 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $6.76 | Professional | 53 · Discontinued | $6.31 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $24.55 Typical High $25.12 | Professional | 54 · Surgery only | $23.44 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.90 Typical High $5.13 | Professional | 55 · Aftercare only | $4.68 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.39 |
Where Washington sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 34th of 51
$38.90
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.