How much rates vary
Facilitymedian $74 · 10th to 90th $60 to $129Professionalmedian $66 · 10th to 90th $32 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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | None | $45.71 | $51.29 | $51.29 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $79.43 | Facility | None | $58.88 | $74.13 | $79.43 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $66.07 Median $398.11 Typical High $588.84 | Professional | None | $66.07 | $398.11 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Facility | None | $43.65 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Kaiser Permanente Setting Facility Modifier None Typical Low $72.44 Median $93.33 Typical High $138.04 | Facility | None | $72.44 | $93.33 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $154.88 | Professional | None | $70.79 | $93.33 | $154.88 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | None | $60.26 | $60.26 | $77.62 |
Pacific Source Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $79.43 | Facility | None | $60.26 | $74.13 | $79.43 |
Premera BCBS Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $147.91 | Facility | None | $66.07 | $66.07 | $147.91 |
Premera BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | None | $63.10 | $63.10 | $74.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $81.28 | Professional | None | $61.66 | $66.07 | $81.28 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $67.61 | Professional | None | $33.11 | $34.67 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $54.95 Typical High $117.49 | Professional | None | $42.66 | $54.95 | $117.49 |
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 $22.91 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $22.91 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $9.12 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.92 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.57 | $5.13 | $5.13 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | NR · New when rented | $66.07 | $66.07 | $66.07 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | NR · New when rented | $63.10 | $63.10 | $74.13 |
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· 11th of 51
$66.07
MT $83.18DE $31.62
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.