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 $33.11 Median $33.11 Typical High $72.44 | Facility | None | $33.11 | $33.11 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $33.11 Typical High $48.98 | Professional | None | $10.00 | $33.11 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $19.50 Median $29.51 Typical High $38.02 | Professional | None | $19.50 | $29.51 | $38.02 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $16.60 Median $199.53 Typical High $407.38 | Facility | None | $16.60 | $199.53 | $407.38 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $22.39 Median $44.67 Typical High $58.88 | Professional | None | $22.39 | $44.67 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | None | $20.89 | $20.89 | $23.99 |
Pacific Source Setting Facility Modifier None Typical Low $15.85 Median $33.88 Typical High $47.86 | Facility | None | $15.85 | $33.88 | $47.86 |
Premera BCBS Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $28.18 | Facility | None | $22.39 | $22.39 | $28.18 |
Premera BCBS Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $389.05 | Facility | None | $138.04 | $204.17 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $22.39 Median $44.67 Typical High $58.88 | Professional | None | $22.39 | $44.67 | $58.88 |
United Setting Facility Modifier None Typical Low $213.80 Median $281.84 Typical High $426.58 | Facility | None | $213.80 | $281.84 | $426.58 |
United Setting Professional Modifier None Typical Low $14.45 Median $31.62 Typical High $64.57 | Professional | None | $14.45 | $31.62 | $64.57 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $48.98 | Professional | None | $30.90 | $32.36 | $48.98 |
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 $13.49 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $13.49 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $5.37 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $3.98 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.69 | $3.31 | $3.31 |
Where Washington sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 14th of 51
$31.62
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.