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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $117.49 | Facility | None | $89.13 | $109.65 | $117.49 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $97.72 Median $588.84 Typical High $870.96 | Professional | None | $97.72 | $588.84 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $77.62 | Facility | None | $70.79 | $70.79 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Kaiser Permanente Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $204.17 | Facility | None | $109.65 | $138.04 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $234.42 | Professional | None | $109.65 | $141.25 | $234.42 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $95.50 | Professional | None | $77.62 | $87.10 | $95.50 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $117.49 | Facility | None | $109.65 | $112.20 | $117.49 |
Premera BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $218.78 | Facility | None | $100.00 | $100.00 | $218.78 |
Premera BCBS Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | None | $93.33 | $93.33 | $109.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $120.23 | Professional | None | $91.20 | $97.72 | $120.23 |
United Setting Facility Modifier None Typical Low $63.10 Median $169.82 Typical High $169.82 | Facility | None | $63.10 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $100.00 | Professional | None | $51.29 | $51.29 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $173.78 | Professional | None | $67.61 | $81.28 | $173.78 |
3 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 $33.88 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $10.23 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $7.59 |
Where Washington sits
The same service costs 2.4 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
$100
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.