How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $144.54 Typical High $177.83 | Facility | None | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $239.88 | Professional | None | $128.82 | $144.54 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $151.36 | Facility | None | $144.54 | $144.54 | $151.36 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $295.12 Typical High $316.23 | Facility | None | $158.49 | $295.12 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $234.42 | Professional | None | $131.83 | $141.25 | $234.42 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $154.88 | Facility | None | $128.82 | $144.54 | $154.88 |
Premera BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Premera BCBS Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | None | $151.36 | $158.49 | $158.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $169.82 | Professional | None | $138.04 | $154.88 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | None | $123.03 | $134.90 | $134.90 |
4 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 $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Where Washington sits
The same service costs 1.9 times more in Arizona than in New Mexico. 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· 17th of 51
$158
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.