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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $436.52 Median $512.86 Typical High $588.84 | Facility | None | $436.52 | $512.86 | $588.84 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $457.09 Median $3,548.13 Typical High $3,981.07 | Professional | None | $457.09 | $3,548.13 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $371.54 | Facility | None | $338.84 | $338.84 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Kaiser Permanente Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $954.99 | Facility | None | $501.19 | $630.96 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,174.90 | Professional | None | $478.63 | $645.65 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $436.52 | Professional | None | $363.08 | $398.11 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $691.83 | Facility | None | $416.87 | $512.86 | $691.83 |
Pacific Source Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Premera BCBS Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $1,023.29 | Facility | None | $457.09 | $457.09 | $1,023.29 |
Premera BCBS Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $562.34 | Professional | None | $426.58 | $457.09 | $562.34 |
United Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $851.14 | Facility | None | $363.08 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $512.86 | Professional | None | $263.03 | $263.03 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $794.33 | Professional | None | $323.59 | $371.54 | $794.33 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | NR · New when rented | $457.09 | $457.09 | $457.09 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | NR · New when rented | $436.52 | $436.52 | $512.86 |
Where Washington sits
The same service costs 2.8 times more in Wyoming 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· 10th of 51
$457
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.