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 $75.86 Median $87.10 Typical High $144.54 | Facility | None | $75.86 | $87.10 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $131.83 | Professional | None | $75.86 | $87.10 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $165.96 | Professional | None | $60.26 | $89.13 | $165.96 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $43.65 Median $147.91 Typical High $204.17 | Facility | None | $43.65 | $147.91 | $204.17 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $616.60 | Professional | None | $91.20 | $131.83 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $165.96 | Professional | None | $70.79 | $100.00 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $186.21 | Professional | None | $57.54 | $95.50 | $186.21 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $120.23 | Professional | None | $52.48 | $81.28 | $120.23 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $194.98 | Facility | None | $112.20 | $190.55 | $194.98 |
Premera BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $144.54 | Facility | None | $131.83 | $131.83 | $144.54 |
Premera BCBS Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | None | $97.72 | $144.54 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $138.04 Median $147.91 Typical High $204.17 | Facility | None | $138.04 | $147.91 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $173.78 | Professional | None | $91.20 | $131.83 | $173.78 |
United Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $186.21 | Professional | None | $83.18 | $117.49 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $147.91 | Professional | None | $58.88 | $104.71 | $147.91 |
6 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 $43.65 Median $47.86 Typical High $66.07 | Professional | 52 · Reduced service | $43.65 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.13 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $14.13 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $13.18 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $52.48 Median $104.71 Typical High $158.49 | Professional | 25 · Same-day visit | $52.48 | $104.71 | $158.49 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | CG · Policy criteria applied | $138.04 | $138.04 | $138.04 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | GE · Resident, primary care exception | $74.13 | $74.13 | $75.86 |
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· 16th of 51
$105
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.