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 $194.98 Median $194.98 Typical High $323.59 | Facility | None | $194.98 | $194.98 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $331.13 | Professional | None | $181.97 | $194.98 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $213.80 | Professional | None | $100.00 | $123.03 | $213.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Facility | None | $194.98 | $194.98 | $208.93 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $398.11 Typical High $426.58 | Facility | None | $213.80 | $398.11 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $190.55 Typical High $323.59 | Professional | None | $2.69 | $190.55 | $323.59 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $125.89 | Facility | None | $123.03 | $123.03 | $125.89 |
Premera BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Premera BCBS Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | None | $218.78 | $229.09 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $229.09 | Professional | None | $190.55 | $218.78 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Washington sits
The same service costs 549.5 times more in Arizona than in Rhode Island. 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· 25th of 51
$214
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.