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 $0.68 Median $0.68 Typical High $0.76 | Facility | None | $0.68 | $0.68 | $0.76 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.68 Typical High $0.68 | Professional | None | $0.62 | $0.68 | $0.68 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Facility | None | $0.62 | $0.62 | $0.62 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $1.20 | Facility | None | $0.81 | $0.81 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Premera BCBS Setting Facility Modifier None Typical Low $0.89 Median $2.45 Typical High $2.45 | Facility | None | $0.89 | $2.45 | $2.45 |
Premera BCBS Setting Professional Modifier None Typical Low $0.68 Median $0.89 Typical High $0.89 | Professional | None | $0.68 | $0.89 | $0.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Facility | None | $0.62 | $0.62 | $0.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Wellpoint Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.79 | Professional | None | $0.59 | $0.59 | $0.79 |
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 $0.31 Median $0.34 Typical High $0.34 | Professional | 52 · Reduced service | $0.31 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.12 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.07 |
Where Washington sits
The same service costs 4.7 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· 17th of 51
$0.68
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.