How much rates vary
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 $83.18 Median $91.20 Typical High $112.20 | Facility | None | $83.18 | $91.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $112.20 | Professional | None | $75.86 | $91.20 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | None | $64.57 | $64.57 | $79.43 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $58.88 Median $70.79 Typical High $85.11 | Facility | None | $58.88 | $70.79 | $85.11 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $204.17 | Professional | None | $74.13 | $97.72 | $204.17 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $102.33 Typical High $295.12 | Professional | None | $31.62 | $102.33 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $158.49 | Facility | None | $117.49 | $151.36 | $158.49 |
Premera BCBS Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Premera BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $229.09 | Professional | None | $100.00 | $125.89 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $165.96 | Professional | None | $79.43 | $79.43 | $165.96 |
3 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 $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where Washington sits
The same service costs 2.1 times more in Oregon 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
$97.72
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.