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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $18.62 | Professional | None | $13.18 | $14.45 | $18.62 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $13.18 Median $15.14 Typical High $20.89 | Facility | None | $13.18 | $15.14 | $20.89 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $26.30 | Facility | None | $17.38 | $17.38 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Pacific Source Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Premera BCBS Setting Facility Modifier None Typical Low $11.48 Median $12.88 Typical High $36.31 | Facility | None | $11.48 | $12.88 | $36.31 |
Premera BCBS Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $13.18 Median $15.14 Typical High $20.89 | Facility | None | $13.18 | $15.14 | $20.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
United Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Wellpoint Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $17.38 | Professional | None | $13.18 | $13.18 | $17.38 |
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 $6.76 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $6.76 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.69 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.00 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.35 | $1.45 | $1.45 |
Where Washington sits
The same service costs 1.5 times more in Alaska than in Delaware. 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· 43rd of 51
$13.18
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.