How much rates vary
Facilitymedian $34 · 10th to 90th $28 to $59Professionalmedian $30 · 10th to 90th $18 to $85
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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $23.44 | Professional | None | $20.42 | $23.44 | $23.44 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $26.92 Median $33.11 Typical High $35.48 | Facility | None | $26.92 | $33.11 | $35.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $29.51 Median $181.97 Typical High $263.03 | Professional | None | $29.51 | $181.97 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Facility | None | $24.55 | $24.55 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Kaiser Permanente Setting Facility Modifier None Typical Low $33.11 Median $41.69 Typical High $61.66 | Facility | None | $33.11 | $41.69 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $70.79 | Professional | None | $31.62 | $42.66 | $70.79 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $60.26 Typical High $60.26 | Professional | None | $35.48 | $60.26 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $27.54 Median $33.88 Typical High $34.67 | Facility | None | $27.54 | $33.88 | $34.67 |
Premera BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $67.61 | Facility | None | $30.20 | $30.20 | $67.61 |
Premera BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | None | $28.84 | $28.84 | $33.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $37.15 | Professional | None | $28.18 | $29.51 | $37.15 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $14.79 Median $15.85 Typical High $30.90 | Professional | None | $14.79 | $15.85 | $30.90 |
Wellpoint Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $52.48 | Professional | None | $18.62 | $24.55 | $52.48 |
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 $10.23 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $10.23 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $4.17 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.09 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.04 | $2.29 | $2.29 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | NR · New when rented | $30.20 | $30.20 | $30.20 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | NR · New when rented | $28.84 | $28.84 | $33.11 |
Where Washington sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$30.20
MT $37.15WV $17.78
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.