How much rates vary
Facilitymedian $126 · 10th to 90th $100 to $219Professionalmedian $112 · 10th to 90th $46 to $245
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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | None | $77.62 | $83.18 | $83.18 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $125.89 | Facility | None | $83.18 | $112.20 | $125.89 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $112.20 Median $660.69 Typical High $741.31 | Professional | None | $112.20 | $660.69 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Facility | None | $60.26 | $60.26 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $60.26 | Professional | None | $43.65 | $43.65 | $60.26 |
Kaiser Permanente Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $234.42 | Facility | None | $123.03 | $154.88 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $234.42 | Professional | None | $117.49 | $154.88 | $234.42 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | None | $89.13 | $97.72 | $107.15 |
Pacific Source Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $128.82 | Facility | None | $102.33 | $125.89 | $128.82 |
Premera BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $251.19 | Facility | None | $112.20 | $112.20 | $251.19 |
Premera BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | None | $107.15 | $107.15 | $125.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $138.04 | Professional | None | $104.71 | $112.20 | $138.04 |
United Setting Facility Modifier None Typical Low $67.61 Median $158.49 Typical High $158.49 | Facility | None | $67.61 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $93.33 | Professional | None | $47.86 | $47.86 | $93.33 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $194.98 | Professional | None | $57.54 | $91.20 | $194.98 |
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 $38.90 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $38.90 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $15.49 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.32 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | NR · New when rented | $112.20 | $112.20 | $112.20 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | NR · New when rented | $107.15 | $107.15 | $125.89 |
Where Washington sits
The same service costs 3.6 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· 3rd of 51
$112
HI $158DE $43.65
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.