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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | None | $41.69 | $41.69 | $53.70 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $56.23 Typical High $67.61 | Facility | None | $30.20 | $56.23 | $67.61 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $64.57 Median $562.34 Typical High $676.08 | Professional | None | $64.57 | $562.34 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $169.82 | Professional | None | $70.79 | $93.33 | $169.82 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $83.18 | Professional | None | $74.13 | $81.28 | $83.18 |
Pacific Source Setting Facility Modifier None Typical Low $66.07 Median $72.44 Typical High $77.62 | Facility | None | $66.07 | $72.44 | $77.62 |
Premera BCBS Setting Facility Modifier None Typical Low $89.13 Median $141.25 Typical High $199.53 | Facility | None | $89.13 | $141.25 | $199.53 |
Premera BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Regence BlueShield Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $79.43 | Professional | None | $60.26 | $64.57 | $79.43 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $60.26 | Professional | None | $31.62 | $31.62 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $112.20 | Professional | None | $64.57 | $75.86 | $112.20 |
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 $20.89 Median $20.89 Typical High $26.30 | Professional | 52 · Reduced service | $20.89 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $10.72 | Professional | 53 · Discontinued | $8.32 | $8.32 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | 54 · Surgery only | $31.62 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.94 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $5.37 |
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· 15th of 51
$61.66
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.