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 $23.44 Median $89.13 Typical High $309.03 | Facility | None | $23.44 | $89.13 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $48.98 Typical High $89.13 | Professional | None | $23.44 | $48.98 | $89.13 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $12.30 Median $165.96 Typical High $338.84 | Facility | None | $12.30 | $165.96 | $338.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $25.70 Median $89.13 Typical High $758.58 | Professional | None | $25.70 | $89.13 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $60.26 Typical High $107.15 | Professional | None | $22.91 | $60.26 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $53.70 Typical High $107.15 | Professional | None | $16.98 | $53.70 | $107.15 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $131.83 | Professional | None | $52.48 | $83.18 | $131.83 |
Pacific Source Setting Facility Modifier None Typical Low $120.23 Median $123.03 Typical High $147.91 | Facility | None | $120.23 | $123.03 | $147.91 |
Premera BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Facility | None | $87.10 | $87.10 | $102.33 |
Premera BCBS Setting Professional Modifier None Typical Low $25.12 Median $87.10 Typical High $102.33 | Professional | None | $25.12 | $87.10 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $338.84 | Facility | None | $134.90 | $177.83 | $338.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $64.57 Typical High $141.25 | Professional | None | $25.70 | $64.57 | $141.25 |
United Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $354.81 | Facility | None | $173.78 | $229.09 | $354.81 |
United Setting Professional Modifier None Typical Low $23.44 Median $60.26 Typical High $109.65 | Professional | None | $23.44 | $60.26 | $109.65 |
Wellpoint Setting Professional Modifier None Typical Low $16.22 Median $87.10 Typical High $128.82 | Professional | None | $16.22 | $87.10 | $128.82 |
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 $11.75 Median $24.55 Typical High $44.67 | Professional | 52 · Reduced service | $11.75 | $24.55 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $10.00 Typical High $17.78 | Professional | 53 · Discontinued | $4.68 | $10.00 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $7.41 Typical High $13.49 | Professional | 55 · Aftercare only | $3.55 | $7.41 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $4.90 Typical High $8.91 | Professional | 56 · Pre-op care only | $2.34 | $4.90 | $8.91 |
Where Washington sits
The same service costs 4.9 times more in Hawaii than in Washington, DC. 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· 5th of 51
$79.43
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.