How much rates vary
Facilitymedian $51 · 10th to 90th $27 to $76Professionalmedian $63 · 10th to 90th $31 to $126
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 $26.92 Median $50.12 Typical High $64.57 | Facility | None | $26.92 | $50.12 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $50.12 Typical High $64.57 | Professional | None | $26.92 | $50.12 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $109.65 | Professional | None | $51.29 | $67.61 | $109.65 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $61.66 | Facility | None | $23.44 | $23.44 | $61.66 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $354.81 | Professional | None | $48.98 | $75.86 | $354.81 |
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 $29.51 Median $46.77 Typical High $77.62 | Professional | None | $29.51 | $46.77 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $39.81 Typical High $87.10 | Professional | None | $22.39 | $39.81 | $87.10 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $83.18 Typical High $158.49 | Professional | None | $34.67 | $83.18 | $158.49 |
Pacific Source Setting Facility Modifier None Typical Low $45.71 Median $112.20 Typical High $114.82 | Facility | None | $45.71 | $112.20 | $114.82 |
Premera BCBS Setting Facility Modifier None Typical Low $74.13 Median $75.86 Typical High $75.86 | Facility | None | $74.13 | $75.86 | $75.86 |
Premera BCBS Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $74.13 | Professional | None | $45.71 | $74.13 | $74.13 |
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 $48.98 Median $72.44 Typical High $100.00 | Professional | None | $48.98 | $72.44 | $100.00 |
United Setting Professional Modifier None Typical Low $31.62 Median $53.70 Typical High $85.11 | Professional | None | $31.62 | $53.70 | $85.11 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $61.66 Typical High $87.10 | Professional | None | $30.90 | $61.66 | $87.10 |
7 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 $19.95 Median $21.88 Typical High $32.36 | Professional | 52 · Reduced service | $19.95 | $21.88 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.46 Typical High $9.77 | Professional | 55 · Aftercare only | $5.89 | $6.46 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $6.46 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | 24 · Unrelated visit after surgery | $48.98 | $48.98 | $54.95 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $52.48 Median $67.61 Typical High $104.71 | Professional | 25 · Same-day visit | $52.48 | $67.61 | $104.71 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $70.79 Median $89.13 Typical High $112.20 | Professional | 93 · Audio-only telehealth | $70.79 | $89.13 | $112.20 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | KX · Policy requirements met | $46.77 | $46.77 | $46.77 |
Where Washington sits
The same service costs 2.4 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· 6th of 51
$63.10
AK $77.62NJ $32.36
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.