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 $104.71 Median $109.65 Typical High $181.97 | Facility | None | $104.71 | $109.65 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $158.49 | Professional | None | $104.71 | $109.65 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $218.78 | Professional | None | $93.33 | $117.49 | $218.78 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $54.95 Median $177.83 Typical High $245.47 | Facility | None | $54.95 | $177.83 | $245.47 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $741.31 | Professional | None | $114.82 | $158.49 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $199.53 | Professional | None | $89.13 | $123.03 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $223.87 | Professional | None | $72.44 | $114.82 | $223.87 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $131.83 | Professional | None | $64.57 | $100.00 | $131.83 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $239.88 | Facility | None | $138.04 | $229.09 | $239.88 |
Premera BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
Premera BCBS Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | None | $120.23 | $173.78 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $165.96 Median $177.83 Typical High $245.47 | Facility | None | $165.96 | $177.83 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $208.93 | Professional | None | $114.82 | $158.49 | $208.93 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $218.78 | Professional | None | $104.71 | $144.54 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $177.83 | Professional | None | $74.13 | $125.89 | $177.83 |
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 $54.95 Median $57.54 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $15.85 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $60.26 Median $109.65 Typical High $141.25 | Professional | 25 · Same-day visit | $60.26 | $109.65 | $141.25 |
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 2.8 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· 18th 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.