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 $173.78 Median $173.78 Typical High $288.40 | Facility | None | $173.78 | $173.78 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | None | $158.49 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $257.04 | Facility | None | $186.21 | $223.87 | $257.04 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $234.42 Median $1,348.96 Typical High $1,995.26 | Professional | None | $234.42 | $1,348.96 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Facility | None | $194.98 | $194.98 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Kaiser Permanente Setting Facility Modifier None Typical Low $257.04 Median $323.59 Typical High $478.63 | Facility | None | $257.04 | $323.59 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $524.81 | Professional | None | $245.47 | $331.13 | $524.81 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | None | $234.42 | $257.04 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $269.15 | Facility | None | $257.04 | $263.03 | $269.15 |
Premera BCBS Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Premera BCBS Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | None | $223.87 | $223.87 | $263.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $288.40 | Professional | None | $218.78 | $234.42 | $288.40 |
United Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $234.42 | Professional | None | $117.49 | $117.49 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $407.38 | Professional | None | $141.25 | $190.55 | $407.38 |
4 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 55 · Aftercare only Typical Low $24.55 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $24.55 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $17.38 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | NR · New when rented | $234.42 | $234.42 | $234.42 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | NR · New when rented | $223.87 | $223.87 | $263.03 |
Where Washington sits
The same service costs 2.6 times more in Montana than in New York. 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· 7th of 51
$234
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.