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 $9.33 Median $9.33 Typical High $10.00 | Facility | None | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | None | $8.51 | $9.33 | $9.33 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $25.70 | Facility | None | $11.22 | $11.22 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Pacific Source Setting Facility Modifier None Typical Low $11.48 Median $14.13 Typical High $28.18 | Facility | None | $11.48 | $14.13 | $28.18 |
Premera BCBS Setting Facility Modifier None Typical Low $16.98 Median $37.15 Typical High $37.15 | Facility | None | $16.98 | $37.15 | $37.15 |
Premera BCBS Setting Professional Modifier None Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | None | $13.18 | $16.98 | $16.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Wellpoint Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | None | $10.96 | $11.22 | $11.22 |
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 $4.27 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $4.27 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $1.74 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.29 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.85 | $0.93 | $0.93 |
Where Washington sits
The same service costs 6.5 times more in Oklahoma 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· 34th of 51
$9.33
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.