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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,659.59 | $1,819.70 | $1,819.70 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $95.50 Median $213.80 Typical High $380.19 | Facility | None | $95.50 | $213.80 | $380.19 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $125.89 Median $5,370.32 Typical High $6,918.31 | Professional | None | $125.89 | $5,370.32 | $6,918.31 |
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 $436.52 Median $3,548.13 Typical High $4,168.69 | Professional | None | $436.52 | $3,548.13 | $4,168.69 |
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 $1,548.82 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,548.82 | $1,659.59 | $2,884.03 |
Premera BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,318.26 | Facility | None | $1,288.25 | $1,288.25 | $1,318.26 |
Premera BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $831.76 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $165.96 | $181.97 | $181.97 |
Where Washington sits
The same service costs 15.1 times more in Arkansas 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· 25th of 51
$295
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.