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 $338.84 Median $338.84 Typical High $416.87 | Facility | None | $338.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $562.34 | Professional | None | $338.84 | $338.84 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $512.86 | Professional | None | $234.42 | $295.12 | $512.86 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $602.56 | Facility | None | $323.59 | $446.68 | $602.56 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $616.60 Typical High $707.95 | Facility | None | $354.81 | $616.60 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $295.12 Median $323.59 Typical High $524.81 | Facility | None | $295.12 | $323.59 | $524.81 |
Premera BCBS Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $831.76 | Facility | None | $363.08 | $602.56 | $831.76 |
Premera BCBS Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | None | $338.84 | $363.08 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $602.56 | Facility | None | $371.54 | $446.68 | $602.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $389.05 | Professional | None | $316.23 | $338.84 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $446.68 | Professional | None | $281.84 | $281.84 | $446.68 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Washington sits
The same service costs 2.9 times more in Arizona than in Alabama. 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· 13th of 51
$363
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.