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 $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.87 Median $0.95 Typical High $0.95 | Professional | None | $0.87 | $0.95 | $0.95 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.85 Median $1.23 Typical High $1.62 | Facility | None | $0.85 | $1.23 | $1.62 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Cigna Setting Facility Modifier None Typical Low $1.15 Median $1.15 Typical High $1.91 | Facility | None | $1.15 | $1.15 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Pacific Source Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
Premera BCBS Setting Facility Modifier None Typical Low $0.68 Median $1.23 Typical High $3.16 | Facility | None | $0.68 | $1.23 | $3.16 |
Premera BCBS Setting Professional Modifier None Typical Low $0.71 Median $0.91 Typical High $0.91 | Professional | None | $0.71 | $0.91 | $0.91 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.81 Median $1.23 Typical High $1.62 | Facility | None | $0.81 | $1.23 | $1.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
United Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Wellpoint Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $1.12 | Professional | None | $0.62 | $0.62 | $1.12 |
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 $0.44 Median $0.48 Typical High $0.48 | Professional | 52 · Reduced service | $0.44 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.19 Typical High $0.19 | Professional | 53 · Discontinued | $0.17 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.13 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.09 | $0.10 | $0.10 |
Where Washington sits
The same service costs 4.1 times more in Oklahoma than in North Dakota. 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· 44th of 51
$0.91
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.