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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | None | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $24.55 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $13.49 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $120.23 Median $162.18 Typical High $162.18 | Facility | None | $120.23 | $162.18 | $162.18 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,148.15 | Professional | None | $891.25 | $891.25 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $302.00 | Professional | None | $144.54 | $204.17 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Premera BCBS Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $446.68 | Facility | None | $190.55 | $281.84 | $446.68 |
Premera BCBS Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | None | $63.10 | $66.07 | $66.07 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | None | $144.54 | $181.97 | $181.97 |
3 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Washington sits
The same service costs 2.4 times more in Montana than in Utah. 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
$135
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.