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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | None | $147.91 | $158.49 | $158.49 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $141.25 Median $162.18 Typical High $223.87 | Facility | None | $141.25 | $162.18 | $223.87 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $288.40 | Facility | None | $190.55 | $190.55 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $213.80 | Facility | None | $141.25 | $141.25 | $213.80 |
Premera BCBS Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $371.54 | Facility | None | $117.49 | $147.91 | $371.54 |
Premera BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $162.18 Typical High $223.87 | Facility | None | $141.25 | $162.18 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | None | $141.25 | $141.25 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | None | $141.25 | $141.25 | $190.55 |
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 $74.13 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $29.51 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $21.88 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.79 | $15.85 | $15.85 |
Where Washington sits
The same service costs 1.5 times more in Arizona than in Oregon. 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· 22nd of 51
$148
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.