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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $4.79 | Professional | None | $3.80 | $3.80 | $4.79 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $4.90 Median $6.17 Typical High $6.76 | Facility | None | $4.90 | $6.17 | $6.76 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $5.75 Median $33.88 Typical High $51.29 | Professional | None | $5.75 | $33.88 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Kaiser Permanente Setting Facility Modifier None Typical Low $6.31 Median $8.13 Typical High $12.02 | Facility | None | $6.31 | $8.13 | $12.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.17 Median $8.13 Typical High $12.88 | Professional | None | $6.17 | $8.13 | $12.88 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $5.13 Typical High $5.62 | Professional | None | $4.57 | $5.13 | $5.62 |
Pacific Source Setting Facility Modifier None Typical Low $6.03 Median $6.46 Typical High $6.61 | Facility | None | $6.03 | $6.46 | $6.61 |
Premera BCBS Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Premera BCBS Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.46 | Professional | None | $5.50 | $5.50 | $6.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $7.08 | Professional | None | $5.25 | $5.75 | $7.08 |
United Setting Professional Modifier None Typical Low $2.63 Median $2.82 Typical High $5.50 | Professional | None | $2.63 | $2.82 | $5.50 |
Wellpoint Setting Professional Modifier None Typical Low $3.55 Median $4.79 Typical High $10.23 | Professional | None | $3.55 | $4.79 | $10.23 |
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 $1.91 Median $1.91 Typical High $2.40 | Professional | 52 · Reduced service | $1.91 | $1.91 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $0.95 | Professional | 53 · Discontinued | $0.76 | $0.76 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.72 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.48 |
Where Washington sits
The same service costs 2.1 times more in Kansas than in Alabama. 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
$5.75
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.