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 $1.02 Median $1.02 Typical High $1.02 | Facility | None | $1.02 | $1.02 | $1.02 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.29 | Professional | None | $1.02 | $1.02 | $1.29 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.35 Median $1.66 Typical High $1.86 | Facility | None | $1.35 | $1.66 | $1.86 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1.55 Median $9.12 Typical High $13.80 | Professional | None | $1.55 | $9.12 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.15 | Facility | None | $1.10 | $1.10 | $1.15 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | None | $0.93 | $0.93 | $0.93 |
Kaiser Permanente Setting Facility Modifier None Typical Low $1.74 Median $2.19 Typical High $3.24 | Facility | None | $1.74 | $2.19 | $3.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.66 Median $2.24 Typical High $3.80 | Professional | None | $1.66 | $2.24 | $3.80 |
Molina Setting Professional Modifier None Typical Low $1.12 Median $1.38 Typical High $1.51 | Professional | None | $1.12 | $1.38 | $1.51 |
Pacific Source Setting Facility Modifier None Typical Low $1.62 Median $1.78 Typical High $1.82 | Facility | None | $1.62 | $1.78 | $1.82 |
Premera BCBS Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
Premera BCBS Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.74 | Professional | None | $1.51 | $1.51 | $1.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.45 Median $1.55 Typical High $1.95 | Professional | None | $1.45 | $1.55 | $1.95 |
United Setting Professional Modifier None Typical Low $0.72 Median $0.78 Typical High $1.51 | Professional | None | $0.72 | $0.78 | $1.51 |
Wellpoint Setting Professional Modifier None Typical Low $0.95 Median $1.29 Typical High $2.75 | Professional | None | $0.95 | $1.29 | $2.75 |
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 $0.51 Median $0.51 Typical High $0.65 | Professional | 52 · Reduced service | $0.51 | $0.51 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.26 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.20 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.13 |
Where Washington sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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
$1.55
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.