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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $12.02 | Professional | None | $9.55 | $9.55 | $12.02 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $30.20 | Facility | None | $12.88 | $12.88 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $14.45 Median $128.82 Typical High $131.83 | Professional | None | $14.45 | $128.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $21.38 Typical High $37.15 | Professional | None | $15.85 | $21.38 | $37.15 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $19.05 | Professional | None | $16.98 | $18.62 | $19.05 |
Pacific Source Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $17.78 | Facility | None | $16.60 | $16.60 | $17.78 |
Premera BCBS Setting Facility Modifier None Typical Low $20.42 Median $32.36 Typical High $45.71 | Facility | None | $20.42 | $32.36 | $45.71 |
Premera BCBS Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $13.80 Median $14.45 Typical High $18.20 | Professional | None | $13.80 | $14.45 | $18.20 |
United Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $13.49 | Professional | None | $7.08 | $7.08 | $13.49 |
Wellpoint Setting Professional Modifier None Typical Low $14.45 Median $16.98 Typical High $25.70 | Professional | None | $14.45 | $16.98 | $25.70 |
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 $4.79 Median $4.79 Typical High $6.03 | Professional | 52 · Reduced service | $4.79 | $4.79 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $2.29 | Professional | 53 · Discontinued | $1.91 | $1.91 | $2.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.24 Median $7.24 Typical High $9.12 | Professional | 54 · Surgery only | $7.24 | $7.24 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.82 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.20 |
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
$14.13
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.