How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1.48 Median $1.48 Typical High $1.48 | Facility | None | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.86 | Professional | None | $1.48 | $1.48 | $1.86 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.70 Median $2.00 Typical High $2.40 | Facility | None | $1.70 | $2.00 | $2.40 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.24 Median $13.18 Typical High $19.95 | Professional | None | $2.24 | $13.18 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.24 Median $3.24 Typical High $5.50 | Professional | None | $2.24 | $3.24 | $5.50 |
Molina Setting Professional Modifier None Typical Low $1.82 Median $2.24 Typical High $2.24 | Professional | None | $1.82 | $2.24 | $2.24 |
Pacific Source Setting Facility Modifier None Typical Low $2.09 Median $2.51 Typical High $2.88 | Facility | None | $2.09 | $2.51 | $2.88 |
Premera BCBS Setting Facility Modifier None Typical Low $2.19 Median $2.29 Typical High $5.01 | Facility | None | $2.19 | $2.29 | $5.01 |
Premera BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $2.82 | Professional | None | $2.14 | $2.24 | $2.82 |
United Setting Professional Modifier None Typical Low $1.07 Median $1.12 Typical High $2.14 | Professional | None | $1.07 | $1.12 | $2.14 |
Wellpoint Setting Professional Modifier None Typical Low $1.17 Median $2.24 Typical High $3.98 | Professional | None | $1.17 | $2.24 | $3.98 |
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 $0.74 Median $0.74 Typical High $0.93 | Professional | 52 · Reduced service | $0.74 | $0.74 | $0.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $0.38 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.22 Typical High $0.27 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.18 |
Where Washington sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$2.19
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.