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 $85.11 Median $4,677.35 Typical High $21,877.62 | Facility | None | $85.11 | $4,677.35 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $269.15 | Professional | None | $70.79 | $162.18 | $269.15 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $40.74 Median $295.12 Typical High $407.38 | Facility | None | $40.74 | $295.12 | $407.38 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $91.20 Median $446.68 Typical High $1,698.24 | Professional | None | $91.20 | $446.68 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $512.86 | Professional | None | $79.43 | $194.98 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $478.63 | Professional | None | $85.11 | $169.82 | $478.63 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $323.59 Typical High $512.86 | Professional | None | $158.49 | $323.59 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $398.11 | Facility | None | $204.17 | $331.13 | $398.11 |
Premera BCBS Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $549.54 | Facility | None | $263.03 | $398.11 | $549.54 |
Premera BCBS Setting Professional Modifier None Typical Low $89.13 Median $263.03 Typical High $275.42 | Professional | None | $89.13 | $263.03 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $269.15 Median $295.12 Typical High $407.38 | Facility | None | $269.15 | $295.12 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $213.80 Typical High $446.68 | Professional | None | $91.20 | $213.80 | $446.68 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $83.18 Median $204.17 Typical High $501.19 | Professional | None | $83.18 | $204.17 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $295.12 | Professional | None | $63.10 | $112.20 | $295.12 |
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 $42.66 Median $74.13 Typical High $134.90 | Professional | 52 · Reduced service | $42.66 | $74.13 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $29.51 Typical High $54.95 | Professional | 53 · Discontinued | $16.98 | $29.51 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $112.20 Typical High $204.17 | Professional | 54 · Surgery only | $63.10 | $112.20 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $22.39 Typical High $40.74 | Professional | 55 · Aftercare only | $12.59 | $22.39 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $14.79 Typical High $26.92 | Professional | 56 · Pre-op care only | $8.51 | $14.79 | $26.92 |
Where Washington sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 1st of 51
$288
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.