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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | None | $79.43 | $85.11 | $85.11 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $154.88 | Facility | None | $77.62 | $102.33 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Pacific Source Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $117.49 | Facility | None | $39.81 | $39.81 | $117.49 |
Premera BCBS Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $81.28 | Facility | None | $69.18 | $81.28 | $81.28 |
Premera BCBS Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | None | $67.61 | $69.18 | $69.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $194.98 | Facility | None | $77.62 | $77.62 | $194.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | None | $57.54 | $57.54 | $100.00 |
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 $38.90 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $38.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
Where Washington sits
The same service costs 3.6 times more in Texas than in Kansas. 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· 43rd of 51
$69.18
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.