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 $0.28 Median $0.28 Typical High $0.31 | Facility | None | $0.28 | $0.28 | $0.31 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.37 | Professional | None | $0.28 | $0.28 | $0.37 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.41 Median $0.46 Typical High $0.55 | Facility | None | $0.41 | $0.46 | $0.55 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $4.37 | Professional | None | $0.46 | $0.46 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.46 Median $0.68 Typical High $1.35 | Professional | None | $0.46 | $0.68 | $1.35 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | None | $30.20 | $30.20 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $0.43 Median $0.52 Typical High $0.62 | Facility | None | $0.43 | $0.52 | $0.62 |
Premera BCBS Setting Facility Modifier None Typical Low $0.44 Median $0.46 Typical High $1.00 | Facility | None | $0.44 | $0.46 | $1.00 |
Premera BCBS Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | None | $0.44 | $0.44 | $0.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.44 Median $0.46 Typical High $0.56 | Professional | None | $0.44 | $0.46 | $0.56 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.26 Typical High $0.50 | Professional | None | $0.25 | $0.26 | $0.50 |
Wellpoint Setting Professional Modifier None Typical Low $0.22 Median $0.46 Typical High $0.81 | Professional | None | $0.22 | $0.46 | $0.81 |
5 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 $0.15 Median $0.15 Typical High $0.19 | Professional | 52 · Reduced service | $0.15 | $0.15 | $0.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.08 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.06 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | RR · Rental | $0.03 | $0.03 | $0.04 |
Where Washington sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 20th of 51
$0.44
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.