How much rates vary
Facilitymedian $50 · 10th to 90th $41 to $87Professionalmedian $44 · 10th to 90th $26 to $110
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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Professional | None | $30.20 | $34.67 | $34.67 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $39.81 Median $48.98 Typical High $52.48 | Facility | None | $39.81 | $48.98 | $52.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $43.65 Median $269.15 Typical High $389.05 | Professional | None | $43.65 | $269.15 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.90 | Facility | None | $34.67 | $34.67 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Kaiser Permanente Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $91.20 | Facility | None | $48.98 | $61.66 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $104.71 | Professional | None | $46.77 | $63.10 | $104.71 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $42.66 | Professional | None | $35.48 | $38.90 | $42.66 |
Pacific Source Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $51.29 | Facility | None | $40.74 | $50.12 | $51.29 |
Premera BCBS Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $100.00 | Facility | None | $44.67 | $44.67 | $100.00 |
Premera BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | None | $42.66 | $42.66 | $48.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $54.95 | Professional | None | $41.69 | $43.65 | $54.95 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $45.71 | Professional | None | $21.88 | $23.44 | $45.71 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $77.62 | Professional | None | $27.54 | $36.31 | $77.62 |
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 $15.14 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $15.14 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.17 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $4.57 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.02 | $3.47 | $3.47 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | NR · New when rented | $44.67 | $44.67 | $44.67 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | NR · New when rented | $42.66 | $42.66 | $48.98 |
Where Washington sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$44.67
MT $54.95NJ $25.70
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.