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 $0.69 Median $0.71 Typical High $0.71 | Facility | None | $0.69 | $0.71 | $0.71 |
Aetna Setting Professional Modifier None Typical Low $0.65 Median $0.71 Typical High $0.71 | Professional | None | $0.65 | $0.71 | $0.71 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Cigna Setting Facility Modifier None Typical Low $0.83 Median $0.83 Typical High $1.55 | Facility | None | $0.83 | $0.83 | $1.55 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Pacific Source Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $1.07 | Facility | None | $0.79 | $0.79 | $1.07 |
Premera BCBS Setting Facility Modifier None Typical Low $0.51 Median $0.51 Typical High $0.81 | Facility | None | $0.51 | $0.51 | $0.81 |
Premera BCBS Setting Professional Modifier None Typical Low $0.78 Median $0.81 Typical High $0.81 | Professional | None | $0.78 | $0.81 | $0.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Wellpoint Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $0.83 | Professional | None | $0.78 | $0.78 | $0.83 |
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 $0.32 Median $0.35 Typical High $0.35 | Professional | 52 · Reduced service | $0.32 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.13 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.10 | $0.11 | $0.11 |
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 2.6 times more in Texas than in Wyoming. 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· 20th of 51
$0.71
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.