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 $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $4.07 | Professional | None | $2.95 | $3.24 | $4.07 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Pacific Source Setting Facility Modifier None Typical Low $3.24 Median $6.76 Typical High $7.24 | Facility | None | $3.24 | $6.76 | $7.24 |
Premera BCBS Setting Facility Modifier None Typical Low $5.75 Median $7.94 Typical High $7.94 | Facility | None | $5.75 | $7.94 | $7.94 |
Premera BCBS Setting Professional Modifier None Typical Low $4.47 Median $5.75 Typical High $5.75 | Professional | None | $4.47 | $5.75 | $5.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
United Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.17 | Professional | None | $3.63 | $3.63 | $4.17 |
Wellpoint Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
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 $1.48 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.48 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.59 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.44 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.30 | $0.32 | $0.32 |
Where Washington sits
The same service costs 2.8 times more in Wyoming than in Florida. 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· 15th of 51
$3.80
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.