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 $36.31 Median $36.31 Typical High $38.02 | Facility | None | $36.31 | $36.31 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | None | $33.11 | $36.31 | $36.31 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $27.54 Median $36.31 Typical High $44.67 | Facility | None | $27.54 | $36.31 | $44.67 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $138.04 | Professional | None | $36.31 | $36.31 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $63.10 | Facility | None | $31.62 | $50.12 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $60.26 | Professional | None | $32.36 | $40.74 | $60.26 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $44.67 | Professional | None | $34.67 | $36.31 | $44.67 |
Pacific Source Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Premera BCBS Setting Facility Modifier None Typical Low $24.55 Median $30.90 Typical High $75.86 | Facility | None | $24.55 | $30.90 | $75.86 |
Premera BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $27.54 Median $33.88 Typical High $44.67 | Facility | None | $27.54 | $33.88 | $44.67 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | None | $33.88 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | None | $30.90 | $30.90 | $33.11 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $42.66 | Professional | None | $31.62 | $33.11 | $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 $16.60 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $16.60 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.61 | $7.24 | $7.24 |
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 $3.31 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.31 | $3.63 | $3.63 |
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· 4th of 51
$36.31
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.