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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | None | $309.03 | $331.13 | $331.13 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $380.19 Median $489.78 Typical High $512.86 | Facility | None | $380.19 | $489.78 | $512.86 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $436.52 Median $2,884.03 Typical High $3,311.31 | Professional | None | $436.52 | $2,884.03 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $302.00 | Facility | None | $269.15 | $269.15 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Kaiser Permanente Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $912.01 | Facility | None | $489.78 | $616.60 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $977.24 | Professional | None | $467.74 | $630.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $426.58 | Professional | None | $346.74 | $389.05 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $524.81 | Facility | None | $398.11 | $489.78 | $524.81 |
Premera BCBS Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $1,000.00 | Facility | None | $446.68 | $446.68 | $1,000.00 |
Premera BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $537.03 | Professional | None | $416.87 | $436.52 | $537.03 |
United Setting Facility Modifier None Typical Low $288.40 Median $707.95 Typical High $707.95 | Facility | None | $288.40 | $707.95 | $707.95 |
United Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $426.58 | Professional | None | $218.78 | $218.78 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $776.25 | Professional | None | $269.15 | $363.08 | $776.25 |
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 $154.88 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $33.11 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | NR · New when rented | $446.68 | $446.68 | $446.68 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | NR · New when rented | $416.87 | $416.87 | $489.78 |
Where Washington sits
The same service costs 3.3 times more in Hawaii 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
$437
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.