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 $323.59 Median $323.59 Typical High $537.03 | Facility | None | $323.59 | $323.59 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | None | $295.12 | $323.59 | $323.59 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $724.44 | Facility | None | $295.12 | $478.63 | $724.44 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $588.84 | Facility | None | $389.05 | $389.05 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Premera BCBS Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $501.19 | Facility | None | $147.91 | $234.42 | $501.19 |
Premera BCBS Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | None | $398.11 | $407.38 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $724.44 | Facility | None | $295.12 | $478.63 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | None | $346.74 | $346.74 | $380.19 |
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 $147.91 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $32.36 |
Where Washington sits
The same service costs 6.8 times more in Wyoming than in Oklahoma. 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· 6th of 51
$324
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.