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 $128.82 Median $134.90 Typical High $213.80 | Facility | None | $128.82 | $134.90 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $213.80 | Professional | None | $117.49 | $128.82 | $213.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $117.49 Median $218.78 Typical High $302.00 | Facility | None | $117.49 | $218.78 | $302.00 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $380.19 | Facility | None | $154.88 | $154.88 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Premera BCBS Setting Facility Modifier None Typical Low $165.96 Median $194.98 Typical High $524.81 | Facility | None | $165.96 | $194.98 | $524.81 |
Premera BCBS Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | None | $190.55 | $194.98 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $218.78 Typical High $302.00 | Facility | None | $123.03 | $218.78 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | None | $151.36 | $165.96 | $165.96 |
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 $58.88 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $23.44 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $12.88 |
Where Washington sits
The same service costs 2.0 times more in Kansas 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· 15th of 51
$162
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.