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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | None | $33.88 | $40.74 | $40.74 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $15.49 Median $38.02 Typical High $54.95 | Facility | None | $15.49 | $38.02 | $54.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $50.12 | Professional | None | $33.11 | $34.67 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $28.84 Typical High $50.12 | Professional | None | $20.89 | $28.84 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $36.31 | Professional | None | $20.89 | $26.92 | $36.31 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $50.12 | Professional | None | $44.67 | $44.67 | $50.12 |
Pacific Source Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $51.29 | Facility | None | $29.51 | $48.98 | $51.29 |
Premera BCBS Setting Facility Modifier None Typical Low $29.51 Median $33.88 Typical High $33.88 | Facility | None | $29.51 | $33.88 | $33.88 |
Premera BCBS Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | None | $27.54 | $29.51 | $29.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $54.95 | Facility | None | $34.67 | $38.02 | $54.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $46.77 | Professional | None | $33.11 | $34.67 | $46.77 |
United Setting Professional Modifier None Typical Low $29.51 Median $37.15 Typical High $74.13 | Professional | None | $29.51 | $37.15 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $30.20 | Professional | None | $20.89 | $26.30 | $30.20 |
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 $16.98 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $16.98 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $6.76 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.01 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.39 | $4.07 | $4.07 |
Where Washington sits
The same service costs 2.8 times more in New York than in Georgia. 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· 15th of 51
$33.11
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.