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 $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.27 | Professional | None | $3.72 | $3.72 | $4.27 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.89 | Facility | None | $3.24 | $3.24 | $3.89 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | None | $28.18 | $28.18 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $3.72 Median $6.92 Typical High $7.41 | Facility | None | $3.72 | $6.92 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.26 Median $7.94 Typical High $12.02 | Professional | None | $1.26 | $7.94 | $12.02 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | None | $50.12 | $64.57 | $64.57 |
Pacific Source Setting Facility Modifier None Typical Low $5.13 Median $7.94 Typical High $8.71 | Facility | None | $5.13 | $7.94 | $8.71 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.17 Typical High $7.59 | Professional | None | $2.82 | $4.17 | $7.59 |
Wellpoint Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $5.62 | Professional | None | $4.17 | $4.17 | $5.62 |
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 $1.82 Median $1.82 Typical High $2.14 | Professional | 52 · Reduced service | $1.82 | $1.82 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.74 Typical High $0.85 | Professional | 53 · Discontinued | $0.74 | $0.74 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.55 Typical High $0.65 | Professional | 55 · Aftercare only | $0.55 | $0.55 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.42 |
Where Washington sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 36th of 51
$3.72
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.