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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $95.50 Median $204.17 Typical High $354.81 | Facility | None | $95.50 | $204.17 | $354.81 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $125.89 Median $660.69 Typical High $1,096.48 | Professional | None | $125.89 | $660.69 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $295.12 | Facility | None | $151.36 | $186.21 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $363.08 Typical High $457.09 | Professional | None | $128.82 | $363.08 | $457.09 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $208.93 | Professional | None | $50.12 | $123.03 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $181.97 Typical High $257.04 | Facility | None | $177.83 | $181.97 | $257.04 |
Premera BCBS Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $426.58 | Facility | None | $416.87 | $416.87 | $426.58 |
Premera BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $204.17 | Professional | None | $125.89 | $125.89 | $204.17 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $295.12 | Professional | None | $134.90 | $154.88 | $295.12 |
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 $91.20 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $37.15 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $19.95 |
Where Washington sits
The same service costs 3.6 times more in Wyoming than in North Carolina. 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· 9th of 51
$191
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.