How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.58 Median $0.58 Typical High $0.68 | Facility | None | $0.58 | $0.58 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.59 Typical High $0.59 | Professional | None | $0.54 | $0.59 | $0.59 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Facility | None | $0.54 | $0.54 | $0.54 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $1.07 | Facility | None | $0.71 | $0.71 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Pacific Source Setting Facility Modifier None Typical Low $0.58 Median $0.59 Typical High $1.78 | Facility | None | $0.58 | $0.59 | $1.78 |
Premera BCBS Setting Facility Modifier None Typical Low $0.79 Median $1.55 Typical High $1.55 | Facility | None | $0.79 | $1.55 | $1.55 |
Premera BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.79 Typical High $0.79 | Professional | None | $0.62 | $0.79 | $0.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Facility | None | $0.54 | $0.54 | $0.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
United Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Wellpoint Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.71 | Professional | None | $0.52 | $0.52 | $0.71 |
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 $0.27 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.27 | $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 $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
Where Washington sits
The same service costs 6.3 times more in Texas than in Mississippi. 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
$0.58
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.