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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | None | $123.03 | $131.83 | $131.83 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $117.49 Median $120.23 Typical High $177.83 | Facility | None | $117.49 | $120.23 | $177.83 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $239.88 | Facility | None | $158.49 | $158.49 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $131.83 Typical High $177.83 | Facility | None | $117.49 | $131.83 | $177.83 |
Premera BCBS Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $316.23 | Facility | None | $100.00 | $114.82 | $316.23 |
Premera BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $112.20 Median $120.23 Typical High $177.83 | Facility | None | $112.20 | $120.23 | $177.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | None | $120.23 | $120.23 | $158.49 |
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 $61.66 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $24.55 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.30 | $13.18 | $13.18 |
Where Washington sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 21st of 51
$120
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.