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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | None | $61.66 | $61.66 | $77.62 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $109.65 | Facility | None | $83.18 | $100.00 | $109.65 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $93.33 Median $549.54 Typical High $831.76 | Professional | None | $93.33 | $549.54 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Kaiser Permanente Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $194.98 | Facility | None | $104.71 | $131.83 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $204.17 | Professional | None | $100.00 | $134.90 | $204.17 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $107.15 | Facility | None | $85.11 | $104.71 | $107.15 |
Premera BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Premera BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $114.82 | Professional | None | $85.11 | $93.33 | $114.82 |
United Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $89.13 | Professional | None | $43.65 | $45.71 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $165.96 | Professional | None | $69.18 | $77.62 | $165.96 |
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 $30.90 Median $30.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $12.30 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $11.75 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $7.76 |
Where Washington sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 13th of 51
$93.33
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.