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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $60.26 | Professional | None | $20.89 | $20.89 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $33.11 | Facility | None | $28.18 | $28.18 | $33.11 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $31.62 Median $281.84 Typical High $478.63 | Professional | None | $31.62 | $281.84 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $91.20 | Professional | None | $34.67 | $47.86 | $91.20 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $40.74 | Professional | None | $33.11 | $39.81 | $40.74 |
Pacific Source Setting Facility Modifier None Typical Low $33.11 Median $36.31 Typical High $39.81 | Facility | None | $33.11 | $36.31 | $39.81 |
Premera BCBS Setting Facility Modifier None Typical Low $44.67 Median $69.18 Typical High $97.72 | Facility | None | $44.67 | $69.18 | $97.72 |
Premera BCBS Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $38.90 | Professional | None | $30.20 | $31.62 | $38.90 |
United Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $29.51 | Professional | None | $15.49 | $15.49 | $29.51 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $56.23 | Professional | None | $31.62 | $37.15 | $56.23 |
5 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 $10.47 Typical High $13.49 | Professional | 52 · Reduced service | $10.47 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $5.37 | Professional | 53 · Discontinued | $4.17 | $4.17 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $15.49 Typical High $20.42 | Professional | 54 · Surgery only | $15.49 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $4.07 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.69 |
Where Washington sits
The same service costs 3.1 times more in Rhode Island 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· 18th 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.