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 $93.33 Median $5,128.61 Typical High $20,892.96 | Facility | None | $93.33 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $93.33 | Professional | None | $64.57 | $79.43 | $93.33 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Facility | None | $34.67 | $34.67 | $40.74 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $72.44 Median $147.91 Typical High $3,548.13 | Professional | None | $72.44 | $147.91 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $162.18 | Professional | None | $64.57 | $85.11 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $109.65 Typical High $147.91 | Professional | None | $56.23 | $109.65 | $147.91 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $169.82 | Professional | None | $54.95 | $107.15 | $169.82 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $120.23 | Facility | None | $95.50 | $109.65 | $120.23 |
Premera BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Premera BCBS Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | None | $69.18 | $79.43 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $147.91 | Professional | None | $70.79 | $102.33 | $147.91 |
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 $60.26 Median $89.13 Typical High $169.82 | Professional | None | $60.26 | $89.13 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $95.50 | Professional | None | $50.12 | $66.07 | $95.50 |
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 $32.36 Median $39.81 Typical High $46.77 | Professional | 52 · Reduced service | $32.36 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.85 Typical High $18.62 | Professional | 53 · Discontinued | $12.88 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $60.26 Typical High $69.18 | Professional | 54 · Surgery only | $48.98 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $9.77 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.94 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $7.94 | $9.33 |
Where Washington sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 10th of 51
$102
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.