How much rates vary
Facilitymedian $148 · 10th to 90th $123 to $282Professionalmedian $155 · 10th to 90th $138 to $275
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 $158.49 Median $158.49 Typical High $165.96 | Facility | None | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $208.93 | Facility | None | $128.82 | $158.49 | $208.93 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $616.60 | Professional | None | $158.49 | $158.49 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $275.42 | Facility | None | $138.04 | $218.78 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $263.03 | Professional | None | $134.90 | $177.83 | $263.03 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $151.36 Typical High $186.21 | Professional | None | $79.43 | $151.36 | $186.21 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Premera BCBS Setting Facility Modifier None Typical Low $112.20 Median $131.83 Typical High $346.74 | Facility | None | $112.20 | $131.83 | $346.74 |
Premera BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $208.93 | Facility | None | $128.82 | $158.49 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | None | $147.91 | $158.49 | $158.49 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | None | $138.04 | $138.04 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $186.21 | Professional | None | $138.04 | $144.54 | $186.21 |
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 $72.44 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $72.44 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $28.84 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $21.38 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $15.85 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | JW · Drug discarded | $223.87 | $223.87 | $223.87 |
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· 8th of 51
$155
AK $178TN $145
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.