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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $724.44 | Professional | None | $524.81 | $562.34 | $724.44 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $489.78 Median $562.34 Typical High $776.25 | Facility | None | $489.78 | $562.34 | $776.25 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $1,023.29 | Facility | None | $676.08 | $676.08 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $870.96 | Facility | None | $501.19 | $812.83 | $870.96 |
Premera BCBS Setting Facility Modifier None Typical Low $436.52 Median $489.78 Typical High $1,380.38 | Facility | None | $436.52 | $489.78 | $1,380.38 |
Premera BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $489.78 Median $562.34 Typical High $776.25 | Facility | None | $489.78 | $562.34 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $676.08 | Professional | None | $512.86 | $512.86 | $676.08 |
5 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 $263.03 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $56.23 |
Where Washington sits
The same service costs 1.6 times more in Arizona than in Wyoming. 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· 18th of 51
$537
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.