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 $151.36 Typical High $251.19 | Facility | None | $102.33 | $151.36 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $151.36 | Professional | None | $100.00 | $109.65 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $104.71 | Professional | None | $77.62 | $83.18 | $104.71 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $51.29 Median $169.82 Typical High $234.42 | Facility | None | $51.29 | $169.82 | $234.42 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $707.95 | Professional | None | $107.15 | $154.88 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $194.98 | Professional | None | $85.11 | $120.23 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $213.80 | Professional | None | $72.44 | $112.20 | $213.80 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $125.89 | Professional | None | $61.66 | $95.50 | $125.89 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $223.87 | Facility | None | $131.83 | $218.78 | $223.87 |
Premera BCBS Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $169.82 | Facility | None | $151.36 | $151.36 | $169.82 |
Premera BCBS Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | None | $114.82 | $169.82 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $158.49 Median $169.82 Typical High $234.42 | Facility | None | $158.49 | $169.82 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Professional | None | $107.15 | $154.88 | $199.53 |
United Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $213.80 | Professional | None | $97.72 | $138.04 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $169.82 | Professional | None | $69.18 | $123.03 | $169.82 |
4 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 $54.95 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $15.49 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $15.14 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $57.54 Median $134.90 Typical High $229.09 | Professional | 25 · Same-day visit | $57.54 | $134.90 | $229.09 |
Where Washington sits
The same service costs 2.8 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
$126
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.