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 $28.18 Median $28.18 Typical High $30.20 | Facility | None | $28.18 | $28.18 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $28.84 | Professional | None | $25.70 | $28.18 | $28.84 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $20.89 Median $28.18 Typical High $36.31 | Facility | None | $20.89 | $28.18 | $36.31 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $114.82 | Professional | None | $28.18 | $28.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $32.36 Typical High $51.29 | Facility | None | $25.70 | $32.36 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $47.86 | Professional | None | $25.12 | $31.62 | $47.86 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $34.67 | Professional | None | $25.70 | $28.18 | $34.67 |
Pacific Source Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Premera BCBS Setting Facility Modifier None Typical Low $19.50 Median $27.54 Typical High $72.44 | Facility | None | $19.50 | $27.54 | $72.44 |
Premera BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $20.89 Median $28.18 Typical High $36.31 | Facility | None | $20.89 | $28.18 | $36.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | None | $25.70 | $28.18 | $28.18 |
United Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
United Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $27.54 | Professional | None | $25.70 | $25.70 | $27.54 |
Wellpoint Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $33.88 | Professional | None | $25.70 | $25.70 | $33.88 |
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 $12.88 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.13 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $3.89 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.57 | $2.82 | $2.82 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | JZ · No drug discarded | $38.90 | $38.90 | $48.98 |
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· 7th of 51
$28.18
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.