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 $93.33 Median $93.33 Typical High $104.71 | Facility | None | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $151.36 | Facility | None | $85.11 | $109.65 | $151.36 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $363.08 | Professional | None | $93.33 | $93.33 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $165.96 | Facility | None | $81.28 | $128.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $158.49 | Professional | None | $83.18 | $104.71 | $158.49 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $109.65 | Professional | None | $50.12 | $91.20 | $109.65 |
Premera BCBS Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $199.53 | Facility | None | $72.44 | $81.28 | $199.53 |
Premera BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $151.36 | Facility | None | $93.33 | $114.82 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | None | $81.28 | $81.28 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $112.20 | Professional | None | $81.28 | $85.11 | $112.20 |
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 $42.66 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $16.98 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $9.33 |
Where Washington sits
Rates are fairly even across states for this service. 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· 9th of 51
$91.20
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.