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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $213.80 Median $251.19 Typical High $346.74 | Facility | None | $213.80 | $251.19 | $346.74 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $977.24 | Professional | None | $251.19 | $251.19 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $436.52 | Facility | None | $223.87 | $346.74 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $426.58 | Professional | None | $223.87 | $281.84 | $426.58 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $302.00 | Professional | None | $223.87 | $245.47 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $446.68 | Facility | None | $218.78 | $218.78 | $446.68 |
Premera BCBS Setting Facility Modifier None Typical Low $186.21 Median $213.80 Typical High $588.84 | Facility | None | $186.21 | $213.80 | $588.84 |
Premera BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $251.19 Typical High $346.74 | Facility | None | $213.80 | $251.19 | $346.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | None | $223.87 | $223.87 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $295.12 | Professional | None | $223.87 | $229.09 | $295.12 |
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 $114.82 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $45.71 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $22.91 | $25.12 | $25.12 |
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
$245
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.