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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.05 Typical High $23.99 | Professional | None | $18.62 | $19.05 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $30.20 | Facility | None | $25.12 | $25.12 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $28.84 Median $251.19 Typical High $346.74 | Professional | None | $28.84 | $251.19 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $81.28 | Professional | None | $31.62 | $42.66 | $81.28 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $37.15 | Professional | None | $30.20 | $36.31 | $37.15 |
Pacific Source Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.11 | Facility | None | $32.36 | $32.36 | $33.11 |
Premera BCBS Setting Facility Modifier None Typical Low $40.74 Median $63.10 Typical High $89.13 | Facility | None | $40.74 | $63.10 | $89.13 |
Premera BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $35.48 | Professional | None | $27.54 | $28.84 | $35.48 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $26.92 | Professional | None | $14.13 | $14.13 | $26.92 |
Wellpoint Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $51.29 | Professional | None | $28.84 | $33.88 | $51.29 |
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 $9.55 Median $9.55 Typical High $12.02 | Professional | 52 · Reduced service | $9.55 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $4.79 | Professional | 53 · Discontinued | $3.80 | $3.80 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $14.13 Typical High $17.78 | Professional | 54 · Surgery only | $14.13 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.55 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.40 |
Where Washington sits
The same service costs 2.6 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
$27.54
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.