How much rates vary
Facilitymedian $83 · 10th to 90th $74 to $148Professionalmedian $74 · 10th to 90th $56 to $200
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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $56.23 | Professional | None | $52.48 | $56.23 | $56.23 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $89.13 | Facility | None | $67.61 | $83.18 | $89.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $74.13 Median $446.68 Typical High $660.69 | Professional | None | $74.13 | $446.68 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $74.13 | Facility | None | $69.18 | $69.18 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Kaiser Permanente Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $154.88 | Facility | None | $81.28 | $104.71 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $173.78 | Professional | None | $79.43 | $107.15 | $173.78 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $93.33 | Professional | None | $75.86 | $91.20 | $93.33 |
Pacific Source Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $87.10 | Facility | None | $83.18 | $85.11 | $87.10 |
Premera BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $165.96 | Facility | None | $75.86 | $75.86 | $165.96 |
Premera BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | None | $70.79 | $70.79 | $83.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $91.20 | Professional | None | $70.79 | $74.13 | $91.20 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $75.86 | Professional | None | $38.90 | $38.90 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $131.83 | Professional | None | $48.98 | $61.66 | $131.83 |
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 $26.30 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.47 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.76 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.25 | $5.62 | $5.62 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | NR · New when rented | $75.86 | $75.86 | $75.86 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | NR · New when rented | $70.79 | $70.79 | $83.18 |
Where Washington sits
The same service costs 2.0 times more in Montana than in South Carolina. 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
$75.86
MT $93.33SC $46.77
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.