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 $0.54 Median $0.54 Typical High $0.54 | Facility | None | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.68 | Professional | None | $0.54 | $0.54 | $0.68 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.60 Median $0.72 Typical High $0.87 | Facility | None | $0.60 | $0.72 | $0.87 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.81 Median $4.79 Typical High $7.24 | Professional | None | $0.81 | $4.79 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.81 Median $1.17 Typical High $1.74 | Professional | None | $0.81 | $1.17 | $1.74 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | None | $30.20 | $30.20 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $0.74 Median $0.93 Typical High $0.95 | Facility | None | $0.74 | $0.93 | $0.95 |
Premera BCBS Setting Facility Modifier None Typical Low $0.79 Median $0.83 Typical High $1.82 | Facility | None | $0.79 | $0.83 | $1.82 |
Premera BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.78 Median $0.81 Typical High $1.02 | Professional | None | $0.78 | $0.81 | $1.02 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.41 Typical High $0.78 | Professional | None | $0.38 | $0.41 | $0.78 |
Wellpoint Setting Professional Modifier None Typical Low $0.42 Median $0.81 Typical High $1.45 | Professional | None | $0.42 | $0.81 | $1.45 |
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 $0.27 Median $0.27 Typical High $0.33 | Professional | 52 · Reduced service | $0.27 | $0.27 | $0.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.13 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.10 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
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· 12th of 51
$0.79
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.