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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $29.51 | Professional | None | $24.55 | $24.55 | $29.51 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $27.54 Median $33.11 Typical High $39.81 | Facility | None | $27.54 | $33.11 | $39.81 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $37.15 Median $218.78 Typical High $331.13 | Professional | None | $37.15 | $218.78 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $85.11 | Professional | None | $37.15 | $53.70 | $85.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $36.31 | Professional | None | $30.20 | $36.31 | $36.31 |
Pacific Source Setting Facility Modifier None Typical Low $34.67 Median $42.66 Typical High $43.65 | Facility | None | $34.67 | $42.66 | $43.65 |
Premera BCBS Setting Facility Modifier None Typical Low $36.31 Median $38.02 Typical High $83.18 | Facility | None | $36.31 | $38.02 | $83.18 |
Premera BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $46.77 | Professional | None | $35.48 | $37.15 | $46.77 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $37.15 Typical High $66.07 | Professional | None | $19.05 | $37.15 | $66.07 |
5 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 $12.30 Median $12.30 Typical High $15.49 | Professional | 52 · Reduced service | $12.30 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $6.17 | Professional | 53 · Discontinued | $4.90 | $4.90 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $4.68 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $3.09 |
Ambetter Setting Professional Modifier A2 · Dressing, 2 wounds Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | A2 · Dressing, 2 wounds | $43.65 | $43.65 | $43.65 |
Where Washington sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 14th of 51
$36.31
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.