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 $1.38 Median $1.38 Typical High $1.51 | Facility | None | $1.38 | $1.38 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.66 | Professional | None | $1.38 | $1.38 | $1.66 |
Ambetter Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $4.07 | Professional | None | $1.74 | $1.74 | $4.07 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.58 Median $1.86 Typical High $2.24 | Facility | None | $1.58 | $1.86 | $2.24 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.14 Median $12.59 Typical High $18.62 | Professional | None | $2.14 | $12.59 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.14 Median $3.09 Typical High $4.68 | Professional | None | $2.14 | $3.09 | $4.68 |
Molina Setting Professional Modifier None Typical Low $1.70 Median $2.09 Typical High $2.09 | Professional | None | $1.70 | $2.09 | $2.09 |
Pacific Source Setting Facility Modifier None Typical Low $1.95 Median $2.40 Typical High $2.45 | Facility | None | $1.95 | $2.40 | $2.45 |
Premera BCBS Setting Facility Modifier None Typical Low $2.04 Median $2.14 Typical High $4.68 | Facility | None | $2.04 | $2.14 | $4.68 |
Premera BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.04 Median $2.14 Typical High $2.63 | Professional | None | $2.04 | $2.14 | $2.63 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.05 Typical High $2.00 | Professional | None | $1.00 | $1.05 | $2.00 |
Wellpoint Setting Professional Modifier None Typical Low $1.10 Median $2.14 Typical High $3.72 | Professional | None | $1.10 | $2.14 | $3.72 |
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 $0.71 Median $0.71 Typical High $0.87 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.33 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.25 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.17 |
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· 14th of 51
$2.04
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.