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 $0.44 Median $0.44 Typical High $0.44 | Facility | None | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.56 | Professional | None | $0.44 | $0.44 | $0.56 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.50 Median $0.60 Typical High $0.72 | Facility | None | $0.50 | $0.60 | $0.72 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.68 Median $3.98 Typical High $6.03 | Professional | None | $0.68 | $3.98 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.68 Median $0.98 Typical High $1.58 | Professional | None | $0.68 | $0.98 | $1.58 |
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 $0.63 Median $0.76 Typical High $0.78 | Facility | None | $0.63 | $0.76 | $0.78 |
Premera BCBS Setting Facility Modifier None Typical Low $0.65 Median $0.68 Typical High $1.48 | Facility | None | $0.65 | $0.68 | $1.48 |
Premera BCBS Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.65 Median $0.68 Typical High $0.83 | Professional | None | $0.65 | $0.68 | $0.83 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.33 Typical High $0.63 | Professional | None | $0.32 | $0.33 | $0.63 |
Wellpoint Setting Professional Modifier None Typical Low $0.38 Median $0.68 Typical High $1.20 | Professional | None | $0.38 | $0.68 | $1.20 |
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 $0.22 Median $0.22 Typical High $0.27 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.11 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.08 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Where Washington sits
The same service costs 2.6 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· 13th of 51
$0.65
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.