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 $123.03 Median $128.82 Typical High $208.93 | Facility | None | $123.03 | $128.82 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $173.78 | Professional | None | $123.03 | $128.82 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $229.09 | Professional | None | $89.13 | $138.04 | $229.09 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $61.66 Median $194.98 Typical High $269.15 | Facility | None | $61.66 | $194.98 | $269.15 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $812.83 | Professional | None | $128.82 | $177.83 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $218.78 | Professional | None | $100.00 | $138.04 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $251.19 | Professional | None | $81.28 | $128.82 | $251.19 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $316.23 | Professional | None | $74.13 | $104.71 | $316.23 |
Pacific Source Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $257.04 | Facility | None | $151.36 | $251.19 | $257.04 |
Premera BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $190.55 | Facility | None | $173.78 | $173.78 | $190.55 |
Premera BCBS Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | None | $138.04 | $190.55 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $181.97 Median $194.98 Typical High $269.15 | Facility | None | $181.97 | $194.98 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $223.87 | Professional | None | $128.82 | $177.83 | $223.87 |
United Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $245.47 | Professional | None | $117.49 | $158.49 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $194.98 | Professional | None | $83.18 | $138.04 | $194.98 |
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 $61.66 Median $63.10 Typical High $87.10 | Professional | 52 · Reduced service | $61.66 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $17.38 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $128.82 Typical High $234.42 | Professional | 25 · Same-day visit | $114.82 | $128.82 | $234.42 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | GC · Resident with teaching physician | $107.15 | $138.04 | $138.04 |
Where Washington sits
The same service costs 2.7 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
$138
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.