How much rates vary
Facilitymedian $98 · 10th to 90th $79 to $170Professionalmedian $87 · 10th to 90th $43 to $209
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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | None | $60.26 | $67.61 | $67.61 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $104.71 | Facility | None | $77.62 | $97.72 | $104.71 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $87.10 Median $524.81 Typical High $758.58 | Professional | None | $87.10 | $524.81 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Kaiser Permanente Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $181.97 | Facility | None | $95.50 | $123.03 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $204.17 | Professional | None | $91.20 | $123.03 | $204.17 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $109.65 | Professional | None | $87.10 | $97.72 | $109.65 |
Pacific Source Setting Facility Modifier None Typical Low $79.43 Median $97.72 Typical High $102.33 | Facility | None | $79.43 | $97.72 | $102.33 |
Premera BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $194.98 | Facility | None | $87.10 | $87.10 | $194.98 |
Premera BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | None | $83.18 | $83.18 | $97.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $107.15 | Professional | None | $81.28 | $87.10 | $107.15 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
United Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $89.13 | Professional | None | $43.65 | $45.71 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $154.88 | Professional | None | $53.70 | $70.79 | $154.88 |
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 $30.20 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.02 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.03 | $6.76 | $6.76 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | NR · New when rented | $87.10 | $87.10 | $87.10 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | NR · New when rented | $83.18 | $83.18 | $97.72 |
Where Washington sits
The same service costs 2.6 times more in Montana 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· 12th of 51
$87.10
MT $110DE $41.69
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.