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 $30.90 Median $6,165.95 Typical High $27,542.29 | Facility | None | $30.90 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $128.82 | Professional | None | $30.90 | $53.70 | $128.82 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $14.13 Median $537.03 Typical High $1,096.48 | Facility | None | $14.13 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $28.84 Median $114.82 Typical High $691.83 | Professional | None | $28.84 | $114.82 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $46.77 Typical High $128.82 | Professional | None | $20.42 | $46.77 | $128.82 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $162.18 | Professional | None | $53.70 | $89.13 | $162.18 |
Pacific Source Setting Facility Modifier None Typical Low $52.48 Median $165.96 Typical High $169.82 | Facility | None | $52.48 | $165.96 | $169.82 |
Premera BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $114.82 | Facility | None | $112.20 | $112.20 | $114.82 |
Premera BCBS Setting Professional Modifier None Typical Low $29.51 Median $112.20 Typical High $114.82 | Professional | None | $29.51 | $112.20 | $114.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $1,096.48 | Facility | None | $389.05 | $588.84 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.84 Median $74.13 Typical High $141.25 | Professional | None | $28.84 | $74.13 | $141.25 |
United Setting Facility Modifier None Typical Low $588.84 Median $776.25 Typical High $1,202.26 | Facility | None | $588.84 | $776.25 | $1,202.26 |
United Setting Professional Modifier None Typical Low $27.54 Median $64.57 Typical High $123.03 | Professional | None | $27.54 | $64.57 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $81.28 Typical High $117.49 | Professional | None | $19.05 | $81.28 | $117.49 |
5 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 $15.49 Median $24.55 Typical High $64.57 | Professional | 52 · Reduced service | $15.49 | $24.55 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.00 Typical High $26.30 | Professional | 53 · Discontinued | $6.17 | $10.00 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.41 Typical High $19.50 | Professional | 55 · Aftercare only | $4.68 | $7.41 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.01 Typical High $12.88 | Professional | 56 · Pre-op care only | $3.09 | $5.01 | $12.88 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 59 · Distinct service | $50.12 | $50.12 | $50.12 |
Where Washington sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 5th of 51
$85.11
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.