How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $16.22 Median $16.22 Typical High $17.38 | Facility | None | $16.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $16.22 Typical High $26.92 | Professional | None | $10.00 | $16.22 | $26.92 |
Ambetter Setting Professional Modifier None Typical Low $14.13 Median $18.20 Typical High $28.18 | Professional | None | $14.13 | $18.20 | $28.18 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $79.43 | Facility | None | $12.02 | $12.02 | $79.43 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $16.98 Median $31.62 Typical High $41.69 | Professional | None | $16.98 | $31.62 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $16.98 | Professional | None | $12.88 | $12.88 | $16.98 |
Pacific Source Setting Facility Modifier None Typical Low $12.02 Median $23.44 Typical High $28.84 | Facility | None | $12.02 | $23.44 | $28.84 |
Premera BCBS Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $19.95 | Facility | None | $16.60 | $16.60 | $19.95 |
Premera BCBS Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $79.43 | Facility | None | $63.10 | $63.10 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.98 Median $31.62 Typical High $41.69 | Professional | None | $16.98 | $31.62 | $41.69 |
United Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $45.71 | Professional | None | $12.02 | $15.14 | $45.71 |
Wellpoint Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $35.48 | Professional | None | $22.39 | $23.44 | $35.48 |
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 $6.46 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $6.46 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $2.63 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $1.95 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.29 | $1.62 | $1.62 |
Where Washington sits
The same service costs 5.6 times more in Alabama than in Kentucky. 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· 18th of 51
$16.98
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.