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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | None | $20.89 | $21.38 | $21.38 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $17.38 Median $22.91 Typical High $32.36 | Facility | None | $17.38 | $22.91 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $39.81 Typical High $42.66 | Facility | None | $21.38 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Premera BCBS Setting Facility Modifier None Typical Low $16.22 Median $18.62 Typical High $51.29 | Facility | None | $16.22 | $18.62 | $51.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $17.38 Median $21.88 Typical High $29.51 | Facility | None | $17.38 | $21.88 | $29.51 |
United Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Wellpoint Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
5 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 $10.47 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.17 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 54 · Surgery only | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.16 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.14 |
Where Washington sits
The same service costs 39.8 times more in Alabama than in Georgia. 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· 19th of 51
$21.38
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.