How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $64.57 Median $64.57 Typical High $66.07 | Facility | None | $64.57 | $64.57 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $107.15 | Professional | None | $63.10 | $64.57 | $107.15 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $11.22 Median $51.29 Typical High $51.29 | Facility | None | $11.22 | $51.29 | $51.29 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $75.86 Typical High $100.00 | Facility | None | $51.29 | $75.86 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Molina Setting Professional Modifier None Typical Low $7.59 Median $12.59 Typical High $13.49 | Professional | None | $7.59 | $12.59 | $13.49 |
Premera BCBS Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.70 | Facility | None | $25.12 | $25.12 | $25.70 |
Premera BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Regence BlueShield Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Wellpoint Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
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 $31.62 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.59 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.31 | $6.46 | $6.46 |
Where Washington sits
The same service costs 3.0 times more in Kansas than in South Carolina. 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· 49th of 51
$51.29
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.