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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | None | $12.02 | $13.18 | $13.18 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $13.18 | Facility | None | $12.02 | $12.02 | $13.18 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | None | $12.02 | $13.18 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $27.54 | Facility | None | $18.20 | $18.20 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Pacific Source Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Premera BCBS Setting Facility Modifier None Typical Low $13.18 Median $20.42 Typical High $20.42 | Facility | None | $13.18 | $20.42 | $20.42 |
Premera BCBS Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | None | $12.88 | $13.18 | $13.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | None | $12.02 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $14.79 | Professional | None | $12.30 | $12.30 | $14.79 |
Wellpoint Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $15.49 | Professional | None | $11.22 | $11.22 | $15.49 |
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 $6.03 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.03 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.45 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $1.82 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.23 | $1.32 | $1.32 |
Where Washington sits
The same service costs 1.9 times more in Alaska than in Pennsylvania. 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· 26th of 51
$13.18
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.