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 $26.30 Median $6,165.95 Typical High $27,542.29 | Facility | None | $26.30 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $42.66 Typical High $69.18 | Professional | None | $26.30 | $42.66 | $69.18 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $204.17 | Facility | None | $20.42 | $20.42 | $204.17 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $436.52 | Professional | None | $46.77 | $100.00 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $2,691.53 | Facility | None | $707.95 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $128.82 | Professional | None | $45.71 | $77.62 | $128.82 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $112.20 Typical High $194.98 | Professional | None | $19.50 | $112.20 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $57.54 Median $89.13 Typical High $104.71 | Facility | None | $57.54 | $89.13 | $104.71 |
Premera BCBS Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
Premera BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $72.44 | Professional | None | $45.71 | $45.71 | $72.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $125.89 | Professional | None | $45.71 | $72.44 | $125.89 |
United Setting Facility Modifier None Typical Low $125.89 Median $295.12 Typical High $602.56 | Facility | None | $125.89 | $295.12 | $602.56 |
United Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $138.04 | Professional | None | $42.66 | $70.79 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $72.44 | Professional | None | $37.15 | $54.95 | $72.44 |
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 $13.18 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $13.18 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $5.25 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $31.62 Typical High $31.62 | Professional | 54 · Surgery only | $19.95 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $3.98 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $2.63 | $4.27 | $4.27 |
Where Washington sits
The same service costs 2.8 times more in Alaska than in California. 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· 3rd of 51
$97.72
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.