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 $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $3.63 | Professional | None | $2.82 | $2.82 | $3.63 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.72 Median $4.57 Typical High $5.13 | Facility | None | $3.72 | $4.57 | $5.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $4.37 Median $25.12 Typical High $38.02 | Professional | None | $4.37 | $25.12 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.24 | Facility | None | $3.02 | $3.02 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Kaiser Permanente Setting Facility Modifier None Typical Low $4.79 Median $6.03 Typical High $9.12 | Facility | None | $4.79 | $6.03 | $9.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.57 Median $6.17 Typical High $10.00 | Professional | None | $4.57 | $6.17 | $10.00 |
Molina Setting Professional Modifier None Typical Low $3.47 Median $3.80 Typical High $4.27 | Professional | None | $3.47 | $3.80 | $4.27 |
Pacific Source Setting Facility Modifier None Typical Low $4.47 Median $4.90 Typical High $5.01 | Facility | None | $4.47 | $4.90 | $5.01 |
Pacific Source Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Premera BCBS Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Premera BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.79 | Professional | None | $4.17 | $4.17 | $4.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | None | $3.98 | $4.37 | $5.37 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.14 Typical High $4.17 | Professional | None | $2.00 | $2.14 | $4.17 |
Wellpoint Setting Professional Modifier None Typical Low $2.63 Median $3.55 Typical High $7.59 | Professional | None | $2.63 | $3.55 | $7.59 |
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 $1.41 Median $1.41 Typical High $1.82 | Professional | 52 · Reduced service | $1.41 | $1.41 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $0.72 | Professional | 53 · Discontinued | $0.56 | $0.56 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.54 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.36 |
Where Washington sits
The same service costs 2.3 times more in Kansas 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
$4.37
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.