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 $83.18 Median $83.18 Typical High $87.10 | Facility | None | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | None | $83.18 | $83.18 | $95.50 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Facility | None | $72.44 | $72.44 | $87.10 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $154.88 Typical High $165.96 | Facility | None | $83.18 | $154.88 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $295.12 | Professional | None | $125.89 | $229.09 | $295.12 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | None | $50.12 | $64.57 | $64.57 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $177.83 Typical High $194.98 | Facility | None | $95.50 | $177.83 | $194.98 |
United Setting Professional Modifier None Typical Low $41.69 Median $95.50 Typical High $107.15 | Professional | None | $41.69 | $95.50 | $107.15 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $93.33 | Professional | None | $52.48 | $93.33 | $93.33 |
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 $41.69 Median $41.69 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $19.05 | Professional | 53 · Discontinued | $16.60 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $14.45 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $9.55 |
Where Washington sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 34th of 51
$83.18
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.