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 $0.50 Median $0.50 Typical High $0.52 | Facility | None | $0.50 | $0.50 | $0.52 |
Aetna Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.63 | Professional | None | $0.50 | $0.50 | $0.63 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.55 Median $0.68 Typical High $0.81 | Facility | None | $0.55 | $0.68 | $0.81 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.78 Median $4.47 Typical High $6.76 | Professional | None | $0.78 | $4.47 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.78 Median $1.12 Typical High $1.66 | Professional | None | $0.78 | $1.12 | $1.66 |
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 $0.69 Median $0.85 Typical High $0.87 | Facility | None | $0.69 | $0.85 | $0.87 |
Premera BCBS Setting Facility Modifier None Typical Low $0.72 Median $0.78 Typical High $1.70 | Facility | None | $0.72 | $0.78 | $1.70 |
Premera BCBS Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | None | $0.72 | $0.72 | $0.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.72 Median $0.78 Typical High $0.95 | Professional | None | $0.72 | $0.78 | $0.95 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.37 Typical High $0.71 | Professional | None | $0.35 | $0.37 | $0.71 |
Wellpoint Setting Professional Modifier None Typical Low $0.38 Median $0.78 Typical High $1.35 | Professional | None | $0.38 | $0.78 | $1.35 |
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 $0.25 Median $0.25 Typical High $0.32 | Professional | 52 · Reduced service | $0.25 | $0.25 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.12 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
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· 15th of 51
$0.72
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.