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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | None | $91.20 | $100.00 | $100.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $165.96 | Facility | None | $89.13 | $89.13 | $165.96 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $223.87 | Facility | None | $120.23 | $120.23 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Premera BCBS Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $158.49 | Facility | None | $97.72 | $158.49 | $158.49 |
Premera BCBS Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $89.13 Median $151.36 Typical High $208.93 | Facility | None | $89.13 | $151.36 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | None | $97.72 | $97.72 | $117.49 |
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 $45.71 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $45.71 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $10.00 |
Where Washington sits
The same service costs 5.9 times more in Alabama than in Florida. 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· 24th of 51
$97.72
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.