How much rates vary
Facilitymedian $102 · 10th to 90th $87 to $182Professionalmedian $91 · 10th to 90th $46 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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $75.86 | Professional | None | $60.26 | $70.79 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $112.20 | Professional | None | $33.88 | $33.88 | $112.20 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $102.33 | Facility | None | $77.62 | $102.33 | $102.33 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $91.20 Median $537.03 Typical High $741.31 | Professional | None | $91.20 | $537.03 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $67.61 | Facility | None | $60.26 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Kaiser Permanente Setting Facility Modifier None Typical Low $100.00 Median $128.82 Typical High $190.55 | Facility | None | $100.00 | $128.82 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $213.80 | Professional | None | $100.00 | $131.83 | $213.80 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $89.13 | Professional | None | $72.44 | $81.28 | $89.13 |
Pacific Source Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $104.71 | Facility | None | $93.33 | $102.33 | $104.71 |
Premera BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $204.17 | Facility | None | $93.33 | $93.33 | $204.17 |
Premera BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | None | $87.10 | $87.10 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $112.20 | Professional | None | $85.11 | $91.20 | $112.20 |
United Setting Facility Modifier None Typical Low $72.44 Median $154.88 Typical High $154.88 | Facility | None | $72.44 | $154.88 | $154.88 |
United Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $93.33 | Professional | None | $45.71 | $47.86 | $93.33 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $162.18 | Professional | None | $57.54 | $75.86 | $162.18 |
5 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 $31.62 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $31.62 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.59 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.55 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.31 | $7.08 | $7.08 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | GO · Occupational therapy plan | $81.28 | $81.28 | $81.28 |
Where Washington sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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
$91.20
WI $100NJ $47.86
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.