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 $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | None | $26.92 | $26.92 | $33.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $36.31 Typical High $43.65 | Facility | None | $30.20 | $36.31 | $43.65 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $40.74 Median $363.08 Typical High $630.96 | Professional | None | $40.74 | $363.08 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $117.49 | Professional | None | $45.71 | $61.66 | $117.49 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $52.48 | Professional | None | $46.77 | $52.48 | $52.48 |
Pacific Source Setting Facility Modifier None Typical Low $45.71 Median $46.77 Typical High $46.77 | Facility | None | $45.71 | $46.77 | $46.77 |
Premera BCBS Setting Facility Modifier None Typical Low $57.54 Median $89.13 Typical High $125.89 | Facility | None | $57.54 | $89.13 | $125.89 |
Premera BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $50.12 | Professional | None | $38.90 | $40.74 | $50.12 |
United Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $38.02 | Professional | None | $19.95 | $19.95 | $38.02 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $72.44 | Professional | None | $40.74 | $47.86 | $72.44 |
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 $13.49 Median $13.49 Typical High $16.98 | Professional | 52 · Reduced service | $13.49 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $6.76 | Professional | 53 · Discontinued | $5.37 | $5.37 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | 54 · Surgery only | $19.95 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $5.13 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $3.39 |
Where Washington sits
The same service costs 3.2 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· 16th of 51
$38.90
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.