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 $7.41 Median $7.41 Typical High $7.59 | Facility | None | $7.41 | $7.41 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $7.41 Typical High $10.00 | Professional | None | $6.76 | $7.41 | $10.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $18.20 | Facility | None | $8.91 | $8.91 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Pacific Source Setting Facility Modifier None Typical Low $9.12 Median $9.77 Typical High $10.72 | Facility | None | $9.12 | $9.77 | $10.72 |
Premera BCBS Setting Facility Modifier None Typical Low $13.80 Median $39.81 Typical High $39.81 | Facility | None | $13.80 | $39.81 | $39.81 |
Premera BCBS Setting Professional Modifier None Typical Low $10.47 Median $13.80 Typical High $13.80 | Professional | None | $10.47 | $13.80 | $13.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Wellpoint Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $9.12 | Professional | None | $8.71 | $9.12 | $9.12 |
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 $3.39 Median $3.72 Typical High $3.72 | Professional | 52 · Reduced service | $3.39 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.48 Typical High $1.48 | Professional | 53 · Discontinued | $1.35 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $1.02 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.74 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.68 | $0.74 | $0.74 |
Where Washington sits
The same service costs 6.0 times more in Wyoming 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· 28th of 51
$7.41
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.