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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | None | $53.70 | $54.95 | $54.95 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $54.95 Median $89.13 Typical High $104.71 | Facility | None | $54.95 | $89.13 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $102.33 Typical High $109.65 | Facility | None | $54.95 | $102.33 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Premera BCBS Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $204.17 | Facility | None | $69.18 | $69.18 | $204.17 |
Regence BlueShield Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $104.71 | Facility | None | $60.26 | $72.44 | $104.71 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
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 $26.92 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.92 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.50 | $5.50 |
Where Washington sits
The same service costs 1.6 times more in Arizona 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· 31st of 51
$56.23
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.