How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $27.54 Typical High $27.54 | Professional | None | $20.89 | $27.54 | $27.54 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | None | $19.95 | $19.95 | $21.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $22.91 | Facility | None | $19.50 | $19.50 | $22.91 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $31.62 Median $147.91 Typical High $223.87 | Professional | None | $31.62 | $147.91 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.91 Median $51.29 Typical High $69.18 | Professional | None | $22.91 | $51.29 | $69.18 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $53.70 Typical High $87.10 | Professional | None | $26.92 | $53.70 | $87.10 |
Pacific Source Setting Facility Modifier None Typical Low $19.95 Median $44.67 Typical High $52.48 | Facility | None | $19.95 | $44.67 | $52.48 |
Premera BCBS Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $35.48 | Facility | None | $30.90 | $30.90 | $35.48 |
Premera BCBS Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $70.79 | Professional | None | $31.62 | $44.67 | $70.79 |
United Setting Professional Modifier None Typical Low $22.39 Median $33.88 Typical High $81.28 | Professional | None | $22.39 | $33.88 | $81.28 |
Wellpoint Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $60.26 | Professional | None | $26.92 | $36.31 | $60.26 |
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 $10.47 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $10.47 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $4.17 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $3.16 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.09 | $2.75 | $2.75 |
Where Washington sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 4th of 51
$50.12
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.