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 $33.88 Median $33.88 Typical High $107.15 | Facility | None | $33.88 | $33.88 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $72.44 Typical High $107.15 | Professional | None | $33.88 | $72.44 | $107.15 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $17.78 Median $199.53 Typical High $407.38 | Facility | None | $17.78 | $199.53 | $407.38 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $38.90 Median $181.97 Typical High $724.44 | Professional | None | $38.90 | $181.97 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $81.28 Typical High $144.54 | Professional | None | $35.48 | $81.28 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $72.44 Typical High $186.21 | Professional | None | $29.51 | $72.44 | $186.21 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $251.19 | Professional | None | $81.28 | $144.54 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $107.15 Median $147.91 Typical High $169.82 | Facility | None | $107.15 | $147.91 | $169.82 |
Premera BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Premera BCBS Setting Professional Modifier None Typical Low $38.90 Median $114.82 Typical High $114.82 | Professional | None | $38.90 | $114.82 | $114.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $389.05 | Facility | None | $138.04 | $204.17 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.90 Median $97.72 Typical High $165.96 | Professional | None | $38.90 | $97.72 | $165.96 |
United Setting Facility Modifier None Typical Low $213.80 Median $281.84 Typical High $426.58 | Facility | None | $213.80 | $281.84 | $426.58 |
United Setting Professional Modifier None Typical Low $36.31 Median $89.13 Typical High $158.49 | Professional | None | $36.31 | $89.13 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $23.99 Median $85.11 Typical High $190.55 | Professional | None | $23.99 | $85.11 | $190.55 |
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 $16.98 Median $36.31 Typical High $53.70 | Professional | 52 · Reduced service | $16.98 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $14.45 Typical High $21.88 | Professional | 53 · Discontinued | $6.76 | $14.45 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $10.72 Typical High $16.22 | Professional | 55 · Aftercare only | $5.01 | $10.72 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $7.24 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.39 | $7.24 | $10.72 |
Where Washington sits
The same service costs 3.6 times more in North Carolina 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· 3rd of 51
$115
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.