How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $5.37 | Professional | None | $4.37 | $5.13 | $5.37 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $6.61 Median $7.94 Typical High $8.91 | Facility | None | $6.61 | $7.94 | $8.91 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $7.76 Median $63.10 Typical High $562.34 | Professional | None | $7.76 | $63.10 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $5.75 | Facility | None | $4.79 | $5.37 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
Kaiser Permanente Setting Facility Modifier None Typical Low $8.51 Median $10.96 Typical High $16.22 | Facility | None | $8.51 | $10.96 | $16.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.51 Median $11.22 Typical High $17.38 | Professional | None | $8.51 | $11.22 | $17.38 |
Molina Setting Professional Modifier None Typical Low $6.17 Median $6.92 Typical High $7.59 | Professional | None | $6.17 | $6.92 | $7.59 |
Pacific Source Setting Facility Modifier None Typical Low $7.08 Median $7.59 Typical High $8.91 | Facility | None | $7.08 | $7.59 | $8.91 |
Premera BCBS Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Premera BCBS Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $8.71 | Professional | None | $7.41 | $7.41 | $8.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $7.08 Median $7.76 Typical High $9.55 | Professional | None | $7.08 | $7.76 | $9.55 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.80 Typical High $7.41 | Professional | None | $3.55 | $3.80 | $7.41 |
Wellpoint Setting Professional Modifier None Typical Low $3.47 Median $6.46 Typical High $13.80 | Professional | None | $3.47 | $6.46 | $13.80 |
3 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 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.81 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.55 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | KX · Policy requirements met | $6.46 | $6.46 | $6.46 |
Where Washington sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 7th of 51
$7.76
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.