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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.69 | Professional | None | $2.51 | $2.51 | $2.69 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.16 Median $3.80 Typical High $4.37 | Facility | None | $3.16 | $3.80 | $4.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3.89 Median $21.88 Typical High $33.88 | Professional | None | $3.89 | $21.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.69 Typical High $3.31 | Facility | None | $2.34 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Kaiser Permanente Setting Facility Modifier None Typical Low $4.27 Median $5.37 Typical High $7.94 | Facility | None | $4.27 | $5.37 | $7.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.07 Median $5.37 Typical High $8.51 | Professional | None | $4.07 | $5.37 | $8.51 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $3.02 Median $3.72 Typical High $4.47 | Facility | None | $3.02 | $3.72 | $4.47 |
Pacific Source Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Premera BCBS Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Premera BCBS Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.37 | Professional | None | $3.72 | $3.72 | $4.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $4.27 | Professional | None | $3.55 | $3.89 | $4.27 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.91 Typical High $3.72 | Professional | None | $1.74 | $1.91 | $3.72 |
Wellpoint Setting Professional Modifier None Typical Low $2.24 Median $3.16 Typical High $6.76 | Professional | None | $2.24 | $3.16 | $6.76 |
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 $1.26 Median $1.26 Typical High $1.35 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.54 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $0.41 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.27 |
Where Washington sits
The same service costs 2.1 times more in Montana 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· 8th of 51
$3.89
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.