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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | None | $36.31 | $39.81 | $39.81 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $36.31 Median $44.67 Typical High $63.10 | Facility | None | $36.31 | $44.67 | $63.10 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $177.83 | Professional | None | $39.81 | $39.81 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $54.95 Typical High $72.44 | Facility | None | $37.15 | $54.95 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $72.44 | Professional | None | $36.31 | $45.71 | $72.44 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $50.12 | Professional | None | $36.31 | $39.81 | $50.12 |
Premera BCBS Setting Facility Modifier None Typical Low $33.11 Median $41.69 Typical High $104.71 | Facility | None | $33.11 | $41.69 | $104.71 |
Premera BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $36.31 Median $44.67 Typical High $63.10 | Facility | None | $36.31 | $44.67 | $63.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | None | $38.02 | $39.81 | $39.81 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.90 | Professional | None | $36.31 | $36.31 | $38.90 |
Wellpoint Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $46.77 | Professional | None | $36.31 | $37.15 | $46.77 |
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 $18.20 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.24 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.50 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.63 | $3.98 | $3.98 |
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· 11th of 51
$39.81
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.