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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $138.04 | Professional | None | $85.11 | $85.11 | $138.04 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $117.49 | Facility | None | $83.18 | $100.00 | $117.49 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $144.54 Typical High $295.12 | Professional | None | $28.84 | $144.54 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $208.93 | Facility | None | $128.82 | $199.53 | $208.93 |
Premera BCBS Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Premera BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $288.40 | Professional | None | $134.90 | $165.96 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $234.42 | Professional | None | $109.65 | $109.65 | $234.42 |
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 $42.66 Median $42.66 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.33 |
Where Washington sits
The same service costs 3.0 times more in Alaska than in West 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· 14th of 51
$138
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.