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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | None | $42.66 | $46.77 | $46.77 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $70.79 | Facility | None | $42.66 | $42.66 | $70.79 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $85.11 | Facility | None | $56.23 | $56.23 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Premera BCBS Setting Facility Modifier None Typical Low $37.15 Median $44.67 Typical High $125.89 | Facility | None | $37.15 | $44.67 | $125.89 |
Premera BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $42.66 Median $44.67 Typical High $70.79 | Facility | None | $42.66 | $44.67 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | None | $40.74 | $40.74 | $54.95 |
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 $21.38 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $21.38 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.71 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.46 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.27 | $4.68 | $4.68 |
Where Washington sits
The same service costs 1.7 times more in Arizona than in Maryland. 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· 21st of 51
$43.65
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.