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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $60.26 | Professional | None | $53.70 | $58.88 | $60.26 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $107.15 | Facility | None | $70.79 | $70.79 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Premera BCBS Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $54.95 | Facility | None | $48.98 | $48.98 | $54.95 |
Premera BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Wellpoint Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | None | $51.29 | $51.29 | $69.18 |
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 $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $10.96 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.13 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.50 | $5.89 | $5.89 |
Where Washington sits
The same service costs 3.0 times more in Arizona than in Oklahoma. 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
$53.70
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.