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 $97.72 Median $147.91 Typical High $239.88 | Facility | None | $97.72 | $147.91 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $147.91 | Professional | None | $91.20 | $104.71 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $109.65 Typical High $213.80 | Professional | None | $60.26 | $109.65 | $213.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $47.86 Median $162.18 Typical High $223.87 | Facility | None | $47.86 | $162.18 | $223.87 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $691.83 | Professional | None | $100.00 | $147.91 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $181.97 | Professional | None | $77.62 | $112.20 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $208.93 | Professional | None | $64.57 | $107.15 | $208.93 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $128.82 | Professional | None | $57.54 | $89.13 | $128.82 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $213.80 | Facility | None | $154.88 | $208.93 | $213.80 |
Premera BCBS Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $162.18 | Facility | None | $144.54 | $144.54 | $162.18 |
Premera BCBS Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | None | $107.15 | $162.18 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $151.36 Median $165.96 Typical High $223.87 | Facility | None | $151.36 | $165.96 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $190.55 | Professional | None | $100.00 | $147.91 | $190.55 |
United Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $204.17 | Professional | None | $91.20 | $131.83 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $165.96 | Professional | None | $64.57 | $117.49 | $165.96 |
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 $47.86 Median $52.48 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $14.45 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $14.79 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $64.57 Median $109.65 Typical High $128.82 | Professional | 25 · Same-day visit | $64.57 | $109.65 | $128.82 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | GC · Resident with teaching physician | $89.13 | $89.13 | $89.13 |
Where Washington sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 15th of 51
$120
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.