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 $77,624.71 Median $77,624.71 Typical High $77,624.71 | Facility | None | $77,624.71 | $77,624.71 | $77,624.71 |
Aetna Setting Professional Modifier None Typical Low $75,857.76 Median $77,624.71 Typical High $77,624.71 | Professional | None | $75,857.76 | $77,624.71 | $77,624.71 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Facility | None | $77,624.71 | $77,624.71 | $77,624.71 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
Cigna Setting Facility Modifier None Typical Low $77,624.71 Median $134,896.29 Typical High $154,881.66 | Facility | None | $77,624.71 | $134,896.29 | $154,881.66 |
Cigna Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
Premera BCBS Setting Facility Modifier None Typical Low $69,183.10 Median $69,183.10 Typical High $70,794.58 | Facility | None | $69,183.10 | $69,183.10 | $70,794.58 |
Premera BCBS Setting Professional Modifier None Typical Low $70,794.58 Median $70,794.58 Typical High $70,794.58 | Professional | None | $70,794.58 | $70,794.58 | $70,794.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Facility | None | $77,624.71 | $77,624.71 | $77,624.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
United Setting Professional Modifier None Typical Low $75,857.76 Median $75,857.76 Typical High $75,857.76 | Professional | None | $75,857.76 | $75,857.76 | $75,857.76 |
Wellpoint Setting Professional Modifier None Typical Low $69,183.10 Median $69,183.10 Typical High $69,183.10 | Professional | None | $69,183.10 | $69,183.10 | $69,183.10 |
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 $38,018.94 Median $38,904.51 Typical High $38,904.51 | Professional | 52 · Reduced service | $38,018.94 | $38,904.51 | $38,904.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15,135.61 Median $15,488.17 Typical High $15,488.17 | Professional | 53 · Discontinued | $15,135.61 | $15,488.17 | $15,488.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11,481.54 Median $11,748.98 Typical High $11,748.98 | Professional | 55 · Aftercare only | $11,481.54 | $11,748.98 | $11,748.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7,585.78 Median $7,762.47 Typical High $7,762.47 | Professional | 56 · Pre-op care only | $7,585.78 | $7,762.47 | $7,762.47 |
Where Washington sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 28th of 51
$75,858
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.