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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Professional | None | $47.86 | $47.86 | $58.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $64.57 Typical High $77.62 | Facility | None | $30.20 | $64.57 | $77.62 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $72.44 Median $562.34 Typical High $645.65 | Professional | None | $72.44 | $562.34 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $177.83 | Professional | None | $79.43 | $104.71 | $177.83 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $93.33 | Professional | None | $77.62 | $91.20 | $93.33 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Facility | None | $81.28 | $81.28 | $83.18 |
Premera BCBS Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $223.87 | Facility | None | $102.33 | $158.49 | $223.87 |
Premera BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $89.13 | Professional | None | $69.18 | $72.44 | $89.13 |
United Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $67.61 | Professional | None | $35.48 | $35.48 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $128.82 | Professional | None | $72.44 | $85.11 | $128.82 |
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 $23.99 Median $23.99 Typical High $30.20 | Professional | 52 · Reduced service | $23.99 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $12.02 | Professional | 53 · Discontinued | $9.55 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 54 · Surgery only | $35.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $9.12 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $6.03 |
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
$69.18
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.