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 $0.31 Median $0.31 Typical High $0.31 | Facility | None | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.37 | Professional | None | $0.31 | $0.31 | $0.37 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | None | $38.90 | $38.90 | $54.95 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.37 Median $0.41 Typical High $0.50 | Facility | None | $0.37 | $0.41 | $0.50 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.47 Median $2.75 Typical High $4.17 | Professional | None | $0.47 | $2.75 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.47 Median $0.69 Typical High $1.02 | Professional | None | $0.47 | $0.69 | $1.02 |
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 $0.45 Median $0.52 Typical High $0.54 | Facility | None | $0.45 | $0.52 | $0.54 |
Premera BCBS Setting Facility Modifier None Typical Low $0.45 Median $0.48 Typical High $1.02 | Facility | None | $0.45 | $0.48 | $1.02 |
Premera BCBS Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.45 Median $0.47 Typical High $0.58 | Professional | None | $0.45 | $0.47 | $0.58 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.44 | Professional | None | $0.23 | $0.23 | $0.44 |
Wellpoint Setting Professional Modifier None Typical Low $0.25 Median $0.47 Typical High $0.83 | Professional | None | $0.25 | $0.47 | $0.83 |
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 $0.16 Median $0.16 Typical High $0.19 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
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· 16th of 51
$0.45
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.