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 $17.78 Median $7,943.28 Typical High $27,542.29 | Facility | None | $17.78 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $17.78 Typical High $17.78 | Professional | None | $11.48 | $17.78 | $17.78 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $10.47 | Facility | None | $8.71 | $8.71 | $10.47 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $19.05 Median $85.11 Typical High $102.33 | Professional | None | $19.05 | $85.11 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $24.55 Typical High $33.11 | Professional | None | $12.88 | $24.55 | $33.11 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | None | $70.79 | $70.79 | $75.86 |
Pacific Source Setting Facility Modifier None Typical Low $16.22 Median $26.92 Typical High $28.18 | Facility | None | $16.22 | $26.92 | $28.18 |
Premera BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.62 Typical High $18.62 | Facility | None | $18.20 | $18.62 | $18.62 |
Premera BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.05 Median $23.44 Typical High $36.31 | Professional | None | $19.05 | $23.44 | $36.31 |
United Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $36.31 | Professional | None | $13.18 | $14.45 | $36.31 |
Wellpoint Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $22.91 | Professional | None | $11.48 | $15.49 | $22.91 |
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 $6.03 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $6.03 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $2.40 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $13.18 Typical High $13.18 | Professional | 54 · Surgery only | $9.12 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.63 Typical High $2.63 | Professional | 55 · Aftercare only | $1.82 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.20 | $1.78 | $1.78 |
Where Washington sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 15th of 51
$18.20
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.