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 $8.91 Median $8.91 Typical High $48.98 | Facility | None | $8.91 | $8.91 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $8.91 | Professional | None | $8.13 | $8.91 | $8.91 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $48.98 | Professional | None | $8.13 | $8.91 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $19.95 | Facility | None | $10.72 | $10.72 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.68 Median $9.12 Typical High $10.96 | Professional | None | $4.68 | $9.12 | $10.96 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Professional | None | $7.94 | $7.94 | $9.77 |
Pacific Source Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $22.91 | Facility | None | $7.59 | $7.59 | $22.91 |
Premera BCBS Setting Facility Modifier None Typical Low $8.51 Median $9.55 Typical High $9.55 | Facility | None | $8.51 | $9.55 | $9.55 |
Premera BCBS Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Wellpoint Setting Professional Modifier None Typical Low $7.24 Median $8.13 Typical High $10.47 | Professional | None | $7.24 | $8.13 | $10.47 |
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 $4.07 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $4.07 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.78 Typical High $1.78 | Professional | 53 · Discontinued | $1.62 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.23 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.81 | $0.89 | $0.89 |
Where Washington sits
Rates are fairly even across states for this service. 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· 37th of 51
$8.13
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.