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 $11.75 Median $19.50 Typical High $23.44 | Facility | None | $11.75 | $19.50 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $16.60 Typical High $26.30 | Professional | None | $8.71 | $16.60 | $26.30 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $6.03 Median $7.24 Typical High $45.71 | Facility | None | $6.03 | $7.24 | $45.71 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $12.59 Median $26.92 Typical High $169.82 | Professional | None | $12.59 | $26.92 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $14.13 Typical High $22.91 | Facility | None | $12.88 | $14.13 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $19.95 Typical High $43.65 | Professional | None | $11.22 | $19.95 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $23.99 Typical High $43.65 | Professional | None | $15.14 | $23.99 | $43.65 |
Molina Setting Professional Modifier None Typical Low $0.50 Median $4.07 Typical High $12.88 | Professional | None | $0.50 | $4.07 | $12.88 |
Pacific Source Setting Facility Modifier None Typical Low $26.30 Median $33.11 Typical High $35.48 | Facility | None | $26.30 | $33.11 | $35.48 |
Premera BCBS Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.99 | Facility | None | $23.44 | $23.44 | $23.99 |
Premera BCBS Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $23.99 | Professional | None | $12.30 | $12.30 | $23.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.59 Median $23.99 Typical High $43.65 | Professional | None | $12.59 | $23.99 | $43.65 |
United Setting Professional Modifier None Typical Low $12.02 Median $22.91 Typical High $46.77 | Professional | None | $12.02 | $22.91 | $46.77 |
Wellpoint Setting Professional Modifier None Typical Low $10.72 Median $16.22 Typical High $27.54 | Professional | None | $10.72 | $16.22 | $27.54 |
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 $5.89 Median $9.12 Typical High $11.75 | Professional | 52 · Reduced service | $5.89 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $3.63 Typical High $4.68 | Professional | 53 · Discontinued | $2.34 | $3.63 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.75 Typical High $3.55 | Professional | 55 · Aftercare only | $1.78 | $2.75 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.82 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.17 | $1.82 | $2.34 |
Where Washington sits
The same service costs 3.1 times more in Wisconsin than in Louisiana. 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· 15th of 51
$21.88
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.