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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | None | $54.95 | $60.26 | $60.26 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $54.95 Median $72.44 Typical High $109.65 | Facility | None | $54.95 | $72.44 | $109.65 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $60.26 Median $245.47 Typical High $295.12 | Professional | None | $60.26 | $245.47 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $79.43 Typical High $109.65 | Facility | None | $54.95 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $102.33 | Professional | None | $53.70 | $67.61 | $102.33 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $74.13 | Professional | None | $54.95 | $61.66 | $74.13 |
Pacific Source Setting Facility Modifier None Typical Low $67.61 Median $100.00 Typical High $107.15 | Facility | None | $67.61 | $100.00 | $107.15 |
Premera BCBS Setting Facility Modifier None Typical Low $40.74 Median $72.44 Typical High $141.25 | Facility | None | $40.74 | $72.44 | $141.25 |
Premera BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $109.65 | Facility | None | $60.26 | $72.44 | $109.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | None | $56.23 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
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 $27.54 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $27.54 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $10.96 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.32 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.50 | $6.03 | $6.03 |
Where Washington sits
Rates are fairly even across states for this service. 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
$60.26
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.