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 $0.60 Median $0.60 Typical High $0.60 | Facility | None | $0.60 | $0.60 | $0.60 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.60 Typical High $0.60 | Professional | None | $0.55 | $0.60 | $0.60 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Facility | None | $0.55 | $0.55 | $0.55 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $1.10 | Facility | None | $0.71 | $0.71 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Pacific Source Setting Facility Modifier None Typical Low $0.46 Median $0.72 Typical High $0.78 | Facility | None | $0.46 | $0.72 | $0.78 |
Premera BCBS Setting Facility Modifier None Typical Low $0.71 Median $0.85 Typical High $0.85 | Facility | None | $0.71 | $0.85 | $0.85 |
Premera BCBS Setting Professional Modifier None Typical Low $0.68 Median $0.71 Typical High $0.71 | Professional | None | $0.68 | $0.71 | $0.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Facility | None | $0.55 | $0.55 | $0.55 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | None | $0.42 | $0.42 | $0.42 |
Wellpoint Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.72 | Professional | None | $0.60 | $0.60 | $0.72 |
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 $0.28 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.28 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.11 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Washington sits
The same service costs 2.1 times more in Arizona than in Maryland. 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· 12th of 51
$0.60
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.