How much rates vary
Facilitymedian $93 · 10th to 90th $76 to $162Professionalmedian $83 · 10th to 90th $49 to $191
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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $100.00 | Facility | None | $74.13 | $93.33 | $100.00 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $83.18 Median $501.19 Typical High $724.44 | Professional | None | $83.18 | $501.19 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Kaiser Permanente Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $173.78 | Facility | None | $91.20 | $117.49 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $194.98 | Professional | None | $87.10 | $117.49 | $194.98 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $104.71 | Professional | None | $83.18 | $93.33 | $104.71 |
Pacific Source Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $100.00 | Facility | None | $75.86 | $93.33 | $100.00 |
Premera BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $186.21 | Facility | None | $83.18 | $83.18 | $186.21 |
Premera BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | None | $79.43 | $79.43 | $93.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $102.33 | Professional | None | $77.62 | $83.18 | $102.33 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $85.11 | Professional | None | $41.69 | $43.65 | $85.11 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $147.91 | Professional | None | $53.70 | $67.61 | $147.91 |
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 $28.84 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $28.84 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $11.48 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.71 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.75 | $6.46 | $6.46 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | NR · New when rented | $83.18 | $83.18 | $83.18 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | NR · New when rented | $79.43 | $79.43 | $93.33 |
Where Washington sits
The same service costs 2.0 times more in Montana than in Vermont. 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· 10th of 51
$85.11
MT $100VT $48.98
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.