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 $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $35.48 | Professional | None | $32.36 | $35.48 | $35.48 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $32.36 Median $35.48 Typical High $51.29 | Facility | None | $32.36 | $35.48 | $51.29 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $141.25 | Professional | None | $35.48 | $35.48 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $64.57 | Facility | None | $42.66 | $42.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $60.26 | Professional | None | $31.62 | $39.81 | $60.26 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $46.77 | Professional | None | $31.62 | $34.67 | $46.77 |
Pacific Source Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $57.54 | Facility | None | $32.36 | $32.36 | $57.54 |
Premera BCBS Setting Facility Modifier None Typical Low $28.84 Median $32.36 Typical High $89.13 | Facility | None | $28.84 | $32.36 | $89.13 |
Premera BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $32.36 Median $35.48 Typical High $51.29 | Facility | None | $32.36 | $35.48 | $51.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | None | $33.88 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Wellpoint Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | None | $32.36 | $32.36 | $42.66 |
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 $16.22 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $16.22 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $6.46 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.24 | $3.55 | $3.55 |
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· 6th of 51
$35.48
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.