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 $245.47 Median $5,128.61 Typical High $20,892.96 | Facility | None | $245.47 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $245.47 | Professional | None | $75.86 | $169.82 | $245.47 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $34.67 Median $537.03 Typical High $1,096.48 | Facility | None | $34.67 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $95.50 Median $234.42 Typical High $1,258.93 | Professional | None | $95.50 | $234.42 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $181.97 Typical High $316.23 | Professional | None | $89.13 | $181.97 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $446.68 | Professional | None | $104.71 | $208.93 | $446.68 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $263.03 Typical High $426.58 | Professional | None | $46.77 | $263.03 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $346.74 | Facility | None | $251.19 | $295.12 | $346.74 |
Premera BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Facility | None | $229.09 | $229.09 | $234.42 |
Premera BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $234.42 | Professional | None | $97.72 | $97.72 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $1,096.48 | Facility | None | $389.05 | $588.84 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $199.53 Typical High $346.74 | Professional | None | $95.50 | $199.53 | $346.74 |
United Setting Facility Modifier None Typical Low $588.84 Median $776.25 Typical High $1,202.26 | Facility | None | $588.84 | $776.25 | $1,202.26 |
United Setting Professional Modifier None Typical Low $91.20 Median $199.53 Typical High $426.58 | Professional | None | $91.20 | $199.53 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $218.78 | Professional | None | $64.57 | $97.72 | $218.78 |
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 $46.77 Median $79.43 Typical High $123.03 | Professional | 52 · Reduced service | $46.77 | $79.43 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $31.62 Typical High $48.98 | Professional | 53 · Discontinued | $18.62 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $120.23 Typical High $181.97 | Professional | 54 · Surgery only | $69.18 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $23.99 Typical High $36.31 | Professional | 55 · Aftercare only | $13.80 | $23.99 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.85 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.33 | $15.85 | $24.55 |
Where Washington sits
The same service costs 3.5 times more in Alaska 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
$234
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.