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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | None | $109.65 | $120.23 | $120.23 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $158.49 | Facility | None | $100.00 | $114.82 | $158.49 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $218.78 | Facility | None | $144.54 | $144.54 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Pacific Source Setting Facility Modifier None Typical Low $104.71 Median $165.96 Typical High $177.83 | Facility | None | $104.71 | $165.96 | $177.83 |
Premera BCBS Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $269.15 | Facility | None | $85.11 | $102.33 | $269.15 |
Premera BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $158.49 | Facility | None | $100.00 | $114.82 | $158.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
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 $54.95 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $54.95 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.39 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $16.60 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.96 | $12.02 | $12.02 |
Where Washington sits
The same service costs 5.0 times more in Alabama than in Maryland. 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· 29th of 51
$110
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.