How much rates vary
Facilitymedian $81 · 10th to 90th $47 to $126Professionalmedian $83 · 10th to 90th $51 to $138
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 $46.77 Median $81.28 Typical High $102.33 | Facility | None | $46.77 | $81.28 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $102.33 | Professional | None | $46.77 | $81.28 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $131.83 | Professional | None | $58.88 | $77.62 | $131.83 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $81.28 | Facility | None | $30.90 | $30.90 | $81.28 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $457.09 | Professional | None | $66.07 | $97.72 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Facility | None | $125.89 | $125.89 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $120.23 | Professional | None | $51.29 | $75.86 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $138.04 | Professional | None | $44.67 | $70.79 | $138.04 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $85.11 Typical High $158.49 | Professional | None | $45.71 | $85.11 | $158.49 |
Pacific Source Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $144.54 | Facility | None | $85.11 | $141.25 | $144.54 |
Premera BCBS Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Facility | None | $93.33 | $97.72 | $97.72 |
Premera BCBS Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $93.33 | Professional | None | $61.66 | $93.33 | $93.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Facility | None | $169.82 | $169.82 | $213.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $125.89 | Professional | None | $66.07 | $97.72 | $125.89 |
United Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $131.83 | Professional | None | $61.66 | $89.13 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $109.65 | Professional | None | $41.69 | $77.62 | $109.65 |
8 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 $26.92 Median $29.51 Typical High $41.69 | Professional | 52 · Reduced service | $26.92 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $8.13 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.89 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.37 | $5.89 | $8.32 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $66.07 Median $77.62 Typical High $134.90 | Professional | 25 · Same-day visit | $66.07 | $77.62 | $134.90 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 93 · Audio-only telehealth | $123.03 | $123.03 | $123.03 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | GC · Resident with teaching physician | $144.54 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | KX · Policy requirements met | $58.88 | $66.07 | $66.07 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | Q6 · Substitute physician, paid per time | $85.11 | $85.11 | $85.11 |
Where Washington sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 9th of 51
$83.18
AK $107NJ $48.98
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.