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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | None | $18.62 | $19.95 | $19.95 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $22.39 Median $29.51 Typical High $30.20 | Facility | None | $22.39 | $29.51 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $26.92 Median $162.18 Typical High $234.42 | Professional | None | $26.92 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $26.92 | Facility | None | $25.12 | $25.12 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Kaiser Permanente Setting Facility Modifier None Typical Low $29.51 Median $37.15 Typical High $56.23 | Facility | None | $29.51 | $37.15 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $63.10 | Professional | None | $28.18 | $38.02 | $63.10 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $33.11 | Professional | None | $26.92 | $29.51 | $33.11 |
Pacific Source Setting Facility Modifier None Typical Low $30.20 Median $30.90 Typical High $32.36 | Facility | None | $30.20 | $30.90 | $32.36 |
Premera BCBS Setting Facility Modifier None Typical Low $35.48 Median $50.12 Typical High $70.79 | Facility | None | $35.48 | $50.12 | $70.79 |
Premera BCBS Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $44.67 | Professional | None | $28.18 | $30.20 | $44.67 |
Regence BlueShield Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $26.92 Typical High $33.11 | Professional | None | $25.70 | $26.92 | $33.11 |
United Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $27.54 | Professional | None | $14.13 | $14.13 | $27.54 |
Wellpoint Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $46.77 | Professional | None | $21.88 | $25.70 | $46.77 |
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 52 · Reduced service Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $9.33 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.80 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $2.82 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.86 | $2.00 | $2.00 |
Where Washington sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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· 8th of 51
$30.20
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.