How much rates vary
Facilitymedian $22 · 10th to 90th $18 to $38Professionalmedian $19 · 10th to 90th $10 to $44
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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $16.60 Median $21.38 Typical High $22.39 | Facility | None | $16.60 | $21.38 | $22.39 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $19.50 Median $128.82 Typical High $190.55 | Professional | None | $19.50 | $128.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $15.85 | Facility | None | $14.45 | $14.45 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Kaiser Permanente Setting Facility Modifier None Typical Low $21.38 Median $26.92 Typical High $39.81 | Facility | None | $21.38 | $26.92 | $39.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $41.69 | Professional | None | $20.42 | $27.54 | $41.69 |
Molina Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $18.62 | Professional | None | $15.49 | $16.98 | $18.62 |
Pacific Source Setting Facility Modifier None Typical Low $17.78 Median $19.05 Typical High $22.39 | Facility | None | $17.78 | $19.05 | $22.39 |
Premera BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $43.65 | Facility | None | $19.50 | $19.50 | $43.65 |
Premera BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | None | $18.62 | $18.62 | $21.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $23.99 | Professional | None | $18.20 | $19.50 | $23.99 |
United Setting Facility Modifier None Typical Low $12.88 Median $30.90 Typical High $30.90 | Facility | None | $12.88 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $18.62 | Professional | None | $9.33 | $9.33 | $18.62 |
Wellpoint Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $33.88 | Professional | None | $14.13 | $15.85 | $33.88 |
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 $6.76 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $6.76 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.69 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.04 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.35 | $1.45 | $1.45 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | NR · New when rented | $19.50 | $19.50 | $19.50 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | NR · New when rented | $18.62 | $18.62 | $21.38 |
Where Washington sits
The same service costs 3.0 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· 5th of 51
$19.50
HI $31.62DE $10.47
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.