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 $102.33 Median $112.20 Typical High $138.04 | Facility | None | $102.33 | $112.20 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $169.82 | Professional | None | $93.33 | $112.20 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $213.80 | Professional | None | $91.20 | $173.78 | $213.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Facility | None | $79.43 | $79.43 | $95.50 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $134.90 Median $331.13 Typical High $691.83 | Professional | None | $134.90 | $331.13 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $316.23 | Professional | None | $123.03 | $131.83 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $229.09 Typical High $288.40 | Professional | None | $102.33 | $229.09 | $288.40 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $154.88 Typical High $251.19 | Professional | None | $34.67 | $154.88 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $229.09 | Facility | None | $117.49 | $194.98 | $229.09 |
Premera BCBS Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $151.36 | Facility | None | $134.90 | $134.90 | $151.36 |
Premera BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $309.03 | Professional | None | $134.90 | $181.97 | $309.03 |
United Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $363.08 | Professional | None | $117.49 | $144.54 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $218.78 | Professional | None | $107.15 | $144.54 | $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 $51.29 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $18.62 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $12.30 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $144.54 Median $181.97 Typical High $213.80 | Professional | FS · Shared visit | $144.54 | $181.97 | $213.80 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $144.54 Median $199.53 Typical High $204.17 | Professional | GC · Resident with teaching physician | $144.54 | $199.53 | $204.17 |
Where Washington sits
The same service costs 2.5 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· 12th of 51
$148
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.