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 $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.89 | Professional | None | $4.68 | $4.68 | $5.89 |
Ambetter Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $5.37 Median $6.31 Typical High $7.59 | Facility | None | $5.37 | $6.31 | $7.59 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $7.08 Median $41.69 Typical High $63.10 | Professional | None | $7.08 | $41.69 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.08 Median $10.23 Typical High $16.60 | Professional | None | $7.08 | $10.23 | $16.60 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $6.92 | Professional | None | $5.75 | $6.92 | $6.92 |
Pacific Source Setting Facility Modifier None Typical Low $6.61 Median $8.13 Typical High $8.32 | Facility | None | $6.61 | $8.13 | $8.32 |
Premera BCBS Setting Facility Modifier None Typical Low $6.92 Median $7.24 Typical High $15.85 | Facility | None | $6.92 | $7.24 | $15.85 |
Premera BCBS Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $8.91 | Professional | None | $6.76 | $7.08 | $8.91 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.47 Typical High $6.61 | Professional | None | $3.31 | $3.47 | $6.61 |
Wellpoint Setting Professional Modifier None Typical Low $3.63 Median $7.08 Typical High $12.59 | Professional | None | $3.63 | $7.08 | $12.59 |
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 $2.34 Median $2.34 Typical High $2.95 | Professional | 52 · Reduced service | $2.34 | $2.34 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.93 Typical High $1.20 | Professional | 53 · Discontinued | $0.93 | $0.93 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.71 Typical High $0.89 | Professional | 55 · Aftercare only | $0.71 | $0.71 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.47 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.47 | $0.47 | $0.56 |
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
$6.92
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.