How much rates vary
Facilitymedian $117 · 10th to 90th $62 to $170Professionalmedian $129 · 10th to 90th $83 to $251
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 $61.66 Median $114.82 Typical High $151.36 | Facility | None | $61.66 | $114.82 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $144.54 | Professional | None | $61.66 | $114.82 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $213.80 | Professional | None | $95.50 | $131.83 | $213.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $144.54 | Facility | None | $53.70 | $53.70 | $144.54 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $691.83 | Professional | None | $112.20 | $151.36 | $691.83 |
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 $83.18 Median $117.49 Typical High $181.97 | Professional | None | $83.18 | $117.49 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $208.93 | Professional | None | $67.61 | $104.71 | $208.93 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $316.23 | Professional | None | $79.43 | $165.96 | $316.23 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $218.78 | Facility | None | $109.65 | $204.17 | $218.78 |
Premera BCBS Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $147.91 | Facility | None | $144.54 | $147.91 | $147.91 |
Premera BCBS Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | None | $104.71 | $144.54 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $281.84 | Facility | None | $223.87 | $223.87 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $194.98 | Professional | None | $112.20 | $151.36 | $194.98 |
United Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $194.98 | Professional | None | $91.20 | $128.82 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $169.82 | Professional | None | $70.79 | $120.23 | $169.82 |
11 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 $45.71 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $19.05 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $12.59 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $131.83 Typical High $213.80 | Professional | 25 · Same-day visit | $102.33 | $131.83 | $213.80 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 57 · Decision for surgery | $190.55 | $204.17 | $204.17 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $131.83 Median $138.04 Typical High $223.87 | Professional | 93 · Audio-only telehealth | $131.83 | $138.04 | $223.87 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $125.89 Median $199.53 Typical High $223.87 | Professional | GC · Resident with teaching physician | $125.89 | $199.53 | $223.87 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | KX · Policy requirements met | $107.15 | $107.15 | $107.15 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | Q6 · Substitute physician, paid per time | $114.82 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | SA · Nurse practitioner | $60.26 | $60.26 | $60.26 |
Ambetter Setting Professional Modifier UA · State-defined Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | UA · State-defined | $131.83 | $131.83 | $190.55 |
Where Washington sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 12th of 51
$129
AK $170AL $74.13
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.