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 $1.35 Median $1.35 Typical High $1.55 | Facility | None | $1.35 | $1.35 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.35 Typical High $1.35 | Professional | None | $1.23 | $1.35 | $1.35 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $2.40 | Facility | None | $1.62 | $1.62 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Pacific Source Setting Facility Modifier None Typical Low $1.07 Median $1.82 Typical High $1.95 | Facility | None | $1.07 | $1.82 | $1.95 |
Premera BCBS Setting Facility Modifier None Typical Low $1.29 Median $1.78 Typical High $1.78 | Facility | None | $1.29 | $1.78 | $1.78 |
Premera BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.29 Typical High $1.29 | Professional | None | $1.26 | $1.29 | $1.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Wellpoint Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.58 | Professional | None | $1.10 | $1.10 | $1.58 |
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 $0.62 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.62 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.25 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.18 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.12 | $0.13 | $0.13 |
Where Washington sits
The same service costs 3.8 times more in Texas than in Maryland. 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· 22nd of 51
$1.29
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.