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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | None | $10.00 | $10.96 | $10.96 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $19.95 | Facility | None | $13.18 | $13.18 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Pacific Source Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Premera BCBS Setting Facility Modifier None Typical Low $10.00 Median $12.88 Typical High $12.88 | Facility | None | $10.00 | $12.88 | $12.88 |
Premera BCBS Setting Professional Modifier None Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | None | $9.77 | $10.00 | $10.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
United Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Wellpoint Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $12.88 | Professional | None | $8.51 | $8.51 | $12.88 |
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 $5.01 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.01 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.04 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.51 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.00 | $1.10 | $1.10 |
Where Washington sits
The same service costs 2.2 times more in Arkansas than in Rhode Island. 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· 25th of 51
$10.00
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.