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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $38.02 | Professional | None | $29.51 | $29.51 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $87.10 | Professional | None | $39.81 | $53.70 | $87.10 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $39.81 Typical High $46.77 | Facility | None | $30.20 | $39.81 | $46.77 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $44.67 Median $398.11 Typical High $758.58 | Professional | None | $44.67 | $398.11 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $125.89 | Professional | None | $48.98 | $67.61 | $125.89 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $57.54 | Professional | None | $51.29 | $56.23 | $57.54 |
Pacific Source Setting Facility Modifier None Typical Low $44.67 Median $50.12 Typical High $51.29 | Facility | None | $44.67 | $50.12 | $51.29 |
Premera BCBS Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $138.04 | Facility | None | $63.10 | $97.72 | $138.04 |
Premera BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $54.95 | Professional | None | $42.66 | $44.67 | $54.95 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $41.69 | Professional | None | $21.88 | $21.88 | $41.69 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $79.43 | Professional | None | $44.67 | $52.48 | $79.43 |
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 $14.79 Median $14.79 Typical High $18.62 | Professional | 52 · Reduced service | $14.79 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.41 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | 54 · Surgery only | $21.88 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.62 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.72 |
Where Washington sits
The same service costs 2.6 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
$42.66
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.