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 $1.62 Median $1.62 Typical High $1.62 | Facility | None | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $2.04 | Professional | None | $1.62 | $1.62 | $2.04 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $2.19 Median $2.63 Typical High $2.95 | Facility | None | $2.19 | $2.63 | $2.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.51 Median $14.79 Typical High $21.88 | Professional | None | $2.51 | $14.79 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Kaiser Permanente Setting Facility Modifier None Typical Low $2.75 Median $3.47 Typical High $5.25 | Facility | None | $2.75 | $3.47 | $5.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.63 Median $3.55 Typical High $5.50 | Professional | None | $2.63 | $3.55 | $5.50 |
Molina Setting Professional Modifier None Typical Low $2.19 Median $2.45 Typical High $2.75 | Professional | None | $2.19 | $2.45 | $2.75 |
Pacific Source Setting Facility Modifier None Typical Low $2.29 Median $2.82 Typical High $2.88 | Facility | None | $2.29 | $2.82 | $2.88 |
Pacific Source Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Premera BCBS Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Premera BCBS Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.29 Median $2.51 Typical High $3.09 | Professional | None | $2.29 | $2.51 | $3.09 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.23 Typical High $2.40 | Professional | None | $1.15 | $1.23 | $2.40 |
Wellpoint Setting Professional Modifier None Typical Low $1.82 Median $2.04 Typical High $4.37 | Professional | None | $1.82 | $2.04 | $4.37 |
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 $0.81 Median $0.81 Typical High $1.05 | Professional | 52 · Reduced service | $0.81 | $0.81 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.41 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.31 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.21 |
Where Washington sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 13th of 51
$2.51
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.