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 $0.66 Median $0.66 Typical High $0.76 | Facility | None | $0.66 | $0.66 | $0.76 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.66 Typical High $0.66 | Professional | None | $0.60 | $0.66 | $0.66 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Facility | None | $0.60 | $0.60 | $0.60 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $1.20 | Facility | None | $0.89 | $0.89 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Pacific Source Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $1.23 | Facility | None | $0.62 | $0.62 | $1.23 |
Premera BCBS Setting Facility Modifier None Typical Low $1.00 Median $2.00 Typical High $2.00 | Facility | None | $1.00 | $2.00 | $2.00 |
Premera BCBS Setting Professional Modifier None Typical Low $0.76 Median $1.00 Typical High $1.00 | Professional | None | $0.76 | $1.00 | $1.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Facility | None | $0.60 | $0.60 | $0.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
United Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.69 | Professional | None | $0.62 | $0.62 | $0.69 |
Wellpoint Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $0.78 | Professional | None | $0.66 | $0.66 | $0.78 |
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 $0.30 Median $0.33 Typical High $0.33 | Professional | 52 · Reduced service | $0.30 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.12 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.07 |
Where Washington sits
The same service costs 3.4 times more in Wyoming than in Delaware. 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· 23rd of 51
$0.66
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.