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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $181.97 | Professional | None | $138.04 | $144.54 | $181.97 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $204.17 | Facility | None | $128.82 | $128.82 | $204.17 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $257.04 | Facility | None | $169.82 | $169.82 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $194.98 | Facility | None | $128.82 | $128.82 | $194.98 |
Premera BCBS Setting Facility Modifier None Typical Low $112.20 Median $128.82 Typical High $354.81 | Facility | None | $112.20 | $128.82 | $354.81 |
Premera BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $204.17 | Facility | None | $128.82 | $128.82 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | None | $128.82 | $128.82 | $169.82 |
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 $66.07 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.18 | $14.45 | $14.45 |
Where Washington sits
The same service costs 1.6 times more in Texas than in North Carolina. 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· 34th of 51
$129
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.