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 $45.71 Median $45.71 Typical High $51.29 | Facility | None | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $57.54 | Professional | None | $41.69 | $45.71 | $57.54 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $41.69 Median $151.36 Typical High $194.98 | Facility | None | $41.69 | $151.36 | $194.98 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $81.28 | Facility | None | $57.54 | $63.10 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Pacific Source Setting Facility Modifier None Typical Low $63.10 Median $144.54 Typical High $154.88 | Facility | None | $63.10 | $144.54 | $154.88 |
Premera BCBS Setting Facility Modifier None Typical Low $69.18 Median $114.82 Typical High $275.42 | Facility | None | $69.18 | $114.82 | $275.42 |
Premera BCBS Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | None | $66.07 | $87.10 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $147.91 Typical High $194.98 | Facility | None | $100.00 | $147.91 | $194.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | None | $53.70 | $57.54 | $57.54 |
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 $20.89 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $20.89 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $8.32 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.31 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.17 | $4.57 | $4.57 |
Where Washington sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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· 12th of 51
$57.54
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.