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 $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.82 | Professional | None | $1.38 | $1.38 | $1.82 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.24 | Facility | None | $1.86 | $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 $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.34 Median $3.09 Typical High $4.90 | Professional | None | $2.34 | $3.09 | $4.90 |
Molina Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Pacific Source Setting Facility Modifier None Typical Low $2.40 Median $2.45 Typical High $2.69 | Facility | None | $2.40 | $2.45 | $2.69 |
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 $1.29 Median $2.14 Typical High $3.72 | Professional | None | $1.29 | $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 $0.89 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.36 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.27 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.18 |
Where Washington sits
The same service costs 4.6 times more in Rhode Island 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· 23rd of 51
$1.74
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.