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 $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.72 | Professional | None | $2.95 | $2.95 | $3.72 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.80 Median $4.79 Typical High $5.37 | Facility | None | $3.80 | $4.79 | $5.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $4.47 Median $26.30 Typical High $39.81 | Professional | None | $4.47 | $26.30 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.63 | Facility | None | $3.16 | $3.16 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Kaiser Permanente Setting Facility Modifier None Typical Low $5.01 Median $6.31 Typical High $9.33 | Facility | None | $5.01 | $6.31 | $9.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $9.77 | Professional | None | $4.79 | $6.46 | $9.77 |
Molina Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $4.37 | Professional | None | $3.63 | $3.98 | $4.37 |
Pacific Source Setting Facility Modifier None Typical Low $4.68 Median $5.13 Typical High $5.25 | Facility | None | $4.68 | $5.13 | $5.25 |
Premera BCBS Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Premera BCBS Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.01 | Professional | None | $4.37 | $4.37 | $5.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $5.62 | Professional | None | $4.17 | $4.47 | $5.62 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $4.37 | Professional | None | $2.04 | $2.19 | $4.37 |
Wellpoint Setting Professional Modifier None Typical Low $2.75 Median $3.72 Typical High $7.94 | Professional | None | $2.75 | $3.72 | $7.94 |
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 $1.48 Median $1.48 Typical High $1.86 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.76 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.56 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.38 |
Where Washington sits
The same service costs 2.1 times more in Hawaii 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· 12th of 51
$4.47
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.