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 $3.80 | Professional | None | $2.95 | $2.95 | $3.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.89 Median $4.79 Typical High $5.37 | Facility | None | $3.89 | $4.79 | $5.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $4.57 Median $26.92 Typical High $39.81 | Professional | None | $4.57 | $26.92 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $3.55 Typical High $3.80 | Facility | None | $3.39 | $3.55 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Kaiser Permanente Setting Facility Modifier None Typical Low $5.01 Median $6.31 Typical High $9.55 | Facility | None | $5.01 | $6.31 | $9.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $10.00 | Professional | None | $4.79 | $6.46 | $10.00 |
Molina Setting Professional Modifier None Typical Low $3.24 Median $3.98 Typical High $4.47 | Professional | None | $3.24 | $3.98 | $4.47 |
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 $5.13 | Professional | None | $4.37 | $4.37 | $5.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.17 Median $4.57 Typical High $5.62 | Professional | None | $4.17 | $4.57 | $5.62 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.24 Typical High $4.37 | Professional | None | $2.09 | $2.24 | $4.37 |
Wellpoint Setting Professional Modifier None Typical Low $2.63 Median $3.72 Typical High $7.94 | Professional | None | $2.63 | $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 $1.91 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.76 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.56 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $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 2.6 times more in Kansas than in New Hampshire. 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· 13th of 51
$4.57
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.