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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | None | $19.50 | $19.50 | $24.55 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $40.74 | Facility | None | $19.50 | $19.50 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $39.81 Typical High $42.66 | Facility | None | $21.38 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Pacific Source Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $28.84 | Facility | None | $21.88 | $21.88 | $28.84 |
Premera BCBS Setting Facility Modifier None Typical Low $31.62 Median $45.71 Typical High $75.86 | Facility | None | $31.62 | $45.71 | $75.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
United Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
United Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $27.54 | Professional | None | $22.91 | $22.91 | $27.54 |
Wellpoint Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $28.18 | Professional | None | $19.50 | $19.50 | $28.18 |
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 $9.77 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
Where Washington sits
The same service costs 2.0 times more in Alabama than in Connecticut. 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· 39th of 51
$21.38
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.