How much rates vary
Facilitymedian $117 · 10th to 90th $95 to $204Professionalmedian $105 · 10th to 90th $48 to $240
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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | None | $72.44 | $81.28 | $81.28 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $120.23 | Facility | None | $91.20 | $117.49 | $120.23 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $104.71 Median $645.65 Typical High $794.33 | Professional | None | $104.71 | $645.65 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $70.79 | Facility | None | $64.57 | $64.57 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Kaiser Permanente Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $218.78 | Facility | None | $117.49 | $147.91 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $229.09 | Professional | None | $112.20 | $151.36 | $229.09 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | None | $83.18 | $93.33 | $102.33 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $120.23 | Facility | None | $95.50 | $117.49 | $120.23 |
Premera BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $234.42 | Facility | None | $107.15 | $107.15 | $234.42 |
Premera BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $128.82 | Professional | None | $100.00 | $104.71 | $128.82 |
United Setting Facility Modifier None Typical Low $60.26 Median $169.82 Typical High $169.82 | Facility | None | $60.26 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $100.00 | Professional | None | $48.98 | $51.29 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $186.21 | Professional | None | $60.26 | $87.10 | $186.21 |
6 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 $36.31 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $14.45 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $10.96 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.24 | $8.13 | $8.13 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | NR · New when rented | $107.15 | $107.15 | $107.15 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | NR · New when rented | $100.00 | $100.00 | $117.49 |
Where Washington sits
The same service costs 2.8 times more in Wisconsin than in Delaware. 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· 13th of 51
$105
WI $132DE $46.77
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.