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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $34.67 | Professional | None | $31.62 | $34.67 | $34.67 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Facility | None | $47.86 | $47.86 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Premera BCBS Setting Facility Modifier None Typical Low $50.12 Median $72.44 Typical High $72.44 | Facility | None | $50.12 | $72.44 | $72.44 |
Premera BCBS Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | None | $38.90 | $50.12 | $50.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $79.43 | Facility | None | $31.62 | $31.62 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | None | $33.88 | $33.88 | $40.74 |
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 $15.85 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $15.85 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.31 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $4.79 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.16 | $3.47 | $3.47 |
Where Washington sits
The same service costs 2.3 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· 35th of 51
$33.88
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.