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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $107.15 | Professional | None | $83.18 | $83.18 | $107.15 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $112.20 Typical High $134.90 | Facility | None | $30.20 | $112.20 | $134.90 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $128.82 Median $1,122.02 Typical High $1,348.96 | Professional | None | $128.82 | $1,122.02 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $338.84 | Professional | None | $141.25 | $186.21 | $338.84 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $165.96 | Professional | None | $147.91 | $162.18 | $165.96 |
Pacific Source Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $154.88 | Facility | None | $144.54 | $144.54 | $154.88 |
Premera BCBS Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $398.11 | Facility | None | $181.97 | $281.84 | $398.11 |
Premera BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $158.49 | Professional | None | $120.23 | $128.82 | $158.49 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $120.23 | Professional | None | $63.10 | $63.10 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $223.87 | Professional | None | $128.82 | $151.36 | $223.87 |
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 $41.69 Median $41.69 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $16.98 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $79.43 | Professional | 54 · Surgery only | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.85 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $10.72 |
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· 16th of 51
$123
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.