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 $117.49 Median $6,165.95 Typical High $27,542.29 | Facility | None | $117.49 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $912.01 | Professional | None | $117.49 | $173.78 | $912.01 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $69.18 | Facility | None | $57.54 | $57.54 | $69.18 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $123.03 Median $1,000.00 Typical High $6,165.95 | Professional | None | $123.03 | $1,000.00 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $251.19 Typical High $1,288.25 | Professional | None | $109.65 | $251.19 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $588.84 | Professional | None | $81.28 | $186.21 | $588.84 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $1,096.48 Typical High $1,905.46 | Professional | None | $323.59 | $1,096.48 | $1,905.46 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $1,096.48 Typical High $1,318.26 | Facility | None | $257.04 | $1,096.48 | $1,318.26 |
Premera BCBS Setting Facility Modifier None Typical Low $933.25 Median $977.24 Typical High $977.24 | Facility | None | $933.25 | $977.24 | $977.24 |
Premera BCBS Setting Professional Modifier None Typical Low $123.03 Median $275.42 Typical High $933.25 | Professional | None | $123.03 | $275.42 | $933.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $295.12 Typical High $1,380.38 | Professional | None | $123.03 | $295.12 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $3,630.78 Typical High $37,153.52 | Facility | None | $1,122.02 | $3,630.78 | $37,153.52 |
United Setting Professional Modifier None Typical Low $117.49 Median $281.84 Typical High $1,778.28 | Professional | None | $117.49 | $281.84 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $724.44 Typical High $1,071.52 | Professional | None | $75.86 | $724.44 | $1,071.52 |
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 $58.88 Median $87.10 Typical High $457.09 | Professional | 52 · Reduced service | $58.88 | $87.10 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $181.97 | Professional | 53 · Discontinued | $23.44 | $34.67 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $131.83 Typical High $676.08 | Professional | 54 · Surgery only | $89.13 | $131.83 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $138.04 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $91.20 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $91.20 |
Where Washington sits
The same service costs 9.5 times more in Washington 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· 1st of 51
$933
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.