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 $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | None | $11.22 | $11.22 | $13.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $30.20 | Facility | None | $15.14 | $15.14 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $16.98 Median $151.36 Typical High $162.18 | Professional | None | $16.98 | $151.36 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $25.12 Typical High $43.65 | Professional | None | $18.62 | $25.12 | $43.65 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | None | $19.50 | $21.88 | $21.88 |
Pacific Source Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.50 | Facility | None | $19.05 | $19.05 | $19.50 |
Premera BCBS Setting Facility Modifier None Typical Low $23.99 Median $37.15 Typical High $52.48 | Facility | None | $23.99 | $37.15 | $52.48 |
Premera BCBS Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.22 Median $16.98 Typical High $20.89 | Professional | None | $16.22 | $16.98 | $20.89 |
United Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $15.85 | Professional | None | $8.32 | $8.32 | $15.85 |
Wellpoint Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $30.20 | Professional | None | $16.98 | $19.95 | $30.20 |
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 $5.62 Median $5.62 Typical High $7.08 | Professional | 52 · Reduced service | $5.62 | $5.62 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.63 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $8.51 Typical High $10.72 | Professional | 54 · Surgery only | $8.51 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $2.00 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.41 |
Where Washington sits
The same service costs 2.8 times more in Hawaii 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· 14th of 51
$16.22
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.