How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $77.62 Median $87.10 Typical High $95.50 | Facility | None | $77.62 | $87.10 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $125.89 | Professional | None | $70.79 | $87.10 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $141.25 | Professional | None | $70.79 | $112.20 | $141.25 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $63.10 | Facility | None | $52.48 | $52.48 | $63.10 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $93.33 Median $223.87 Typical High $457.09 | Professional | None | $93.33 | $223.87 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $208.93 | Professional | None | $85.11 | $91.20 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $158.49 Typical High $194.98 | Professional | None | $70.79 | $158.49 | $194.98 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $104.71 Typical High $165.96 | Professional | None | $25.70 | $104.71 | $165.96 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $138.04 Typical High $154.88 | Facility | None | $81.28 | $138.04 | $154.88 |
Premera BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $102.33 | Facility | None | $93.33 | $93.33 | $102.33 |
Premera BCBS Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $208.93 | Professional | None | $93.33 | $125.89 | $208.93 |
United Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $245.47 | Professional | None | $81.28 | $100.00 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $144.54 | Professional | None | $70.79 | $95.50 | $144.54 |
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 $36.31 Median $38.90 Typical High $42.66 | Professional | 52 · Reduced service | $36.31 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $12.88 | Professional | 55 · Aftercare only | $10.72 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $7.76 | $8.51 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $70.79 Median $107.15 Typical High $141.25 | Professional | 25 · Same-day visit | $70.79 | $107.15 | $141.25 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $70.79 Median $95.50 Typical High $131.83 | Professional | GC · Resident with teaching physician | $70.79 | $95.50 | $131.83 |
Where Washington sits
The same service costs 2.4 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· 13th of 51
$100
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.