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 $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | None | $27.54 | $35.48 | $35.48 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $38.02 Typical High $69.18 | Facility | None | $30.20 | $38.02 | $69.18 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $302.00 | Professional | None | $251.19 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $32.36 | Facility | None | $30.20 | $30.20 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $74.13 Typical High $93.33 | Professional | None | $37.15 | $74.13 | $93.33 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $60.26 | Professional | None | $44.67 | $50.12 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $53.70 Median $57.54 Typical High $69.18 | Facility | None | $53.70 | $57.54 | $69.18 |
Premera BCBS Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | NR · New when rented | $46.77 | $46.77 | $46.77 |
Premera BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | NR · New when rented | $47.86 | $47.86 | $47.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $48.98 Median $52.48 Typical High $75.86 | Facility | None | $48.98 | $52.48 | $75.86 |
United Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $37.15 | Professional | None | $22.39 | $22.39 | $37.15 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $67.61 | Professional | None | $30.90 | $50.12 | $67.61 |
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 $13.80 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $13.80 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $5.50 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $4.17 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.75 | $3.55 | $3.55 |
Where Washington sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 14th of 51
$38.90
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.