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 $74.13 Median $74.13 Typical High $83.18 | Facility | None | $74.13 | $74.13 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $100.00 | Professional | None | $67.61 | $74.13 | $100.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $67.61 Median $223.87 Typical High $331.13 | Facility | None | $67.61 | $223.87 | $331.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $131.83 | Facility | None | $89.13 | $100.00 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $100.00 | Professional | None | $67.61 | $79.43 | $100.00 |
Pacific Source Setting Facility Modifier None Typical Low $100.00 Median $123.03 Typical High $239.88 | Facility | None | $100.00 | $123.03 | $239.88 |
Premera BCBS Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $380.19 | Facility | None | $107.15 | $158.49 | $380.19 |
Premera BCBS Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $331.13 | Facility | None | $144.54 | $177.83 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | None | $79.43 | $79.43 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | None | $87.10 | $100.00 | $100.00 |
4 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 $33.88 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $33.88 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $7.41 |
Where Washington sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 13th of 51
$89.13
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.