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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $977.24 | Professional | None | $707.95 | $977.24 | $977.24 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Facility | None | $602.56 | $602.56 | $724.44 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,047.13 Median $5,370.32 Typical High $6,606.93 | Professional | None | $1,047.13 | $5,370.32 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,621.81 | Professional | None | $758.58 | $758.58 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,778.28 | Professional | None | $588.84 | $1,023.29 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $1,122.02 Typical High $1,905.46 | Professional | None | $630.96 | $1,122.02 | $1,905.46 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,230.27 Typical High $1,513.56 | Facility | None | $741.31 | $1,230.27 | $1,513.56 |
Premera BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,047.13 | Facility | None | $1,023.29 | $1,023.29 | $1,047.13 |
Premera BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,047.13 | $1,698.24 |
United Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,862.09 | Professional | None | $758.58 | $891.25 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,659.59 | Professional | None | $812.83 | $1,096.48 | $1,659.59 |
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 $371.54 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $97.72 | $97.72 |
Where Washington sits
The same service costs 3.2 times more in Alaska than in New York. 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
$1,072
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.