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 $4.27 Median $4.27 Typical High $5.01 | Facility | None | $4.27 | $4.27 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $4.27 Typical High $5.37 | Professional | None | $3.98 | $4.27 | $5.37 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $9.77 | Facility | None | $5.13 | $5.13 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Pacific Source Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Premera BCBS Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $10.00 | Facility | None | $5.89 | $5.89 | $10.00 |
Premera BCBS Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | None | $9.55 | $10.00 | $10.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Wellpoint Setting Professional Modifier None Typical Low $5.13 Median $9.55 Typical High $9.55 | Professional | None | $5.13 | $9.55 | $9.55 |
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 $2.00 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.00 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.79 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.59 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.40 | $0.43 | $0.43 |
Where Washington sits
The same service costs 3.2 times more in Hawaii than in Georgia. 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· 9th of 51
$9.55
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.