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 $0.42 Median $0.42 Typical High $0.47 | Facility | None | $0.42 | $0.42 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.43 Typical High $0.54 | Professional | None | $0.39 | $0.43 | $0.54 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Facility | None | $0.39 | $0.39 | $0.39 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Cigna Setting Facility Modifier None Typical Low $0.52 Median $0.52 Typical High $0.78 | Facility | None | $0.52 | $0.52 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Pacific Source Setting Facility Modifier None Typical Low $0.55 Median $0.56 Typical High $0.71 | Facility | None | $0.55 | $0.56 | $0.71 |
Premera BCBS Setting Facility Modifier None Typical Low $0.79 Median $2.00 Typical High $2.00 | Facility | None | $0.79 | $2.00 | $2.00 |
Premera BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.79 Typical High $0.79 | Professional | None | $0.62 | $0.79 | $0.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Facility | None | $0.39 | $0.39 | $0.39 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
United Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Wellpoint Setting Professional Modifier None Typical Low $0.51 Median $0.52 Typical High $0.52 | Professional | None | $0.51 | $0.52 | $0.52 |
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 $0.20 Median $0.22 Typical High $0.22 | Professional | 52 · Reduced service | $0.20 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.08 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Washington sits
The same service costs 5.2 times more in Wyoming 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
$0.48
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.