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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | None | $95.50 | $123.03 | $123.03 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $239.88 | Facility | None | $104.71 | $131.83 | $239.88 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | None | $870.96 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Facility | None | $56.23 | $56.23 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $323.59 | Professional | None | $128.82 | $257.04 | $323.59 |
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 $194.98 Median $199.53 Typical High $239.88 | Facility | None | $194.98 | $199.53 | $239.88 |
Premera BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | NR · New when rented | $162.18 | $162.18 | $162.18 |
Premera BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | NR · New when rented | $165.96 | $165.96 | $165.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $181.97 Typical High $263.03 | Facility | None | $169.82 | $181.97 | $263.03 |
United Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $128.82 | Professional | None | $77.62 | $77.62 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $269.15 | Professional | None | $125.89 | $158.49 | $269.15 |
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 $47.86 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $47.86 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $19.50 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $14.45 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $12.30 |
Where Washington sits
The same service costs 4.9 times more in North Dakota 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· 15th of 51
$123
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.