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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $93.33 | Professional | None | $67.61 | $74.13 | $93.33 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $67.61 Median $100.00 Typical High $128.82 | Facility | None | $67.61 | $100.00 | $128.82 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $141.25 | Facility | None | $89.13 | $89.13 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Pacific Source Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $158.49 | Facility | None | $75.86 | $95.50 | $158.49 |
Premera BCBS Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $223.87 | Facility | None | $64.57 | $74.13 | $223.87 |
Premera BCBS Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Regence BlueShield Setting Facility Modifier None Typical Low $74.13 Median $97.72 Typical High $128.82 | Facility | None | $74.13 | $97.72 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | None | $72.44 | $72.44 | $87.10 |
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 $33.88 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $33.88 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $7.41 |
Where Washington sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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· 18th of 51
$74.13
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.