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 $41.69 Median $41.69 Typical High $144.54 | Facility | None | $41.69 | $41.69 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $144.54 | Professional | None | $40.74 | $69.18 | $144.54 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $19.95 Median $338.84 Typical High $741.31 | Facility | None | $19.95 | $338.84 | $741.31 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $42.66 Median $138.04 Typical High $831.76 | Professional | None | $42.66 | $138.04 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $72.44 Typical High $112.20 | Professional | None | $25.70 | $72.44 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $245.47 | Professional | None | $48.98 | $83.18 | $245.47 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $208.93 | Professional | None | $85.11 | $123.03 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $204.17 | Facility | None | $97.72 | $186.21 | $204.17 |
Premera BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Premera BCBS Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $371.54 Typical High $707.95 | Facility | None | $245.47 | $371.54 | $707.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $107.15 Typical High $138.04 | Professional | None | $42.66 | $107.15 | $138.04 |
United Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $794.33 | Facility | None | $389.05 | $512.86 | $794.33 |
United Setting Professional Modifier None Typical Low $33.11 Median $53.70 Typical High $144.54 | Professional | None | $33.11 | $53.70 | $144.54 |
5 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 $20.42 Median $34.67 Typical High $72.44 | Professional | 52 · Reduced service | $20.42 | $34.67 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $13.80 Typical High $28.84 | Professional | 53 · Discontinued | $8.13 | $13.80 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.47 Typical High $21.88 | Professional | 55 · Aftercare only | $6.03 | $10.47 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.92 Typical High $14.45 | Professional | 56 · Pre-op care only | $4.07 | $6.92 | $14.45 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Washington sits
The same service costs 3.5 times more in Hawaii than in Maryland. 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· 3rd of 51
$112
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.