How much rates vary
Facilitymedian $31 · 10th to 90th $25 to $54Professionalmedian $28 · 10th to 90th $12 to $60
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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | None | $19.50 | $20.42 | $20.42 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $21.88 Median $28.84 Typical High $30.90 | Facility | None | $21.88 | $28.84 | $30.90 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $27.54 Median $162.18 Typical High $234.42 | Professional | None | $27.54 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $18.62 | Facility | None | $16.60 | $16.60 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Kaiser Permanente Setting Facility Modifier None Typical Low $30.20 Median $38.90 Typical High $57.54 | Facility | None | $30.20 | $38.90 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $57.54 | Professional | None | $28.84 | $38.90 | $57.54 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $24.55 Typical High $26.92 | Professional | None | $21.88 | $24.55 | $26.92 |
Pacific Source Setting Facility Modifier None Typical Low $25.12 Median $30.90 Typical High $31.62 | Facility | None | $25.12 | $30.90 | $31.62 |
Premera BCBS Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $61.66 | Facility | None | $27.54 | $27.54 | $61.66 |
Premera BCBS Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | None | $26.30 | $26.30 | $30.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $33.88 | Professional | None | $25.70 | $27.54 | $33.88 |
United Setting Facility Modifier None Typical Low $16.22 Median $40.74 Typical High $40.74 | Facility | None | $16.22 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $24.55 | Professional | None | $12.30 | $12.30 | $24.55 |
Wellpoint Setting Professional Modifier None Typical Low $15.85 Median $22.91 Typical High $48.98 | Professional | None | $15.85 | $22.91 | $48.98 |
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 $9.55 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $9.55 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $3.89 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.88 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.95 | $2.04 | $2.04 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | NR · New when rented | $27.54 | $27.54 | $27.54 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | NR · New when rented | $26.30 | $26.30 | $30.90 |
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
$27.54
HI $36.31DE $12.02
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.