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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $181.97 | Professional | None | $117.49 | $117.49 | $181.97 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $128.82 Median $257.04 Typical High $346.74 | Facility | None | $128.82 | $257.04 | $346.74 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $501.19 | Professional | None | $229.09 | $371.54 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Pacific Source Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Premera BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $239.88 | Facility | None | $173.78 | $173.78 | $239.88 |
Premera BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $239.88 Median $257.04 Typical High $346.74 | Facility | None | $239.88 | $257.04 | $346.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $501.19 | Professional | None | $229.09 | $371.54 | $501.19 |
United Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $549.54 | Professional | None | $165.96 | $218.78 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $407.38 | Professional | None | $263.03 | $275.42 | $407.38 |
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 $58.88 Median $58.88 Typical High $91.20 | Professional | 52 · Reduced service | $58.88 | $58.88 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $36.31 | Professional | 53 · Discontinued | $23.44 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $18.20 |
Where Washington sits
The same service costs 20.0 times more in Alaska than in Virginia. 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· 9th of 51
$240
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.