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 $3.89 Median $3.89 Typical High $4.37 | Facility | None | $3.89 | $3.89 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.89 Typical High $3.89 | Professional | None | $3.63 | $3.89 | $3.89 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.55 Median $8.32 Typical High $11.22 | Facility | None | $3.55 | $8.32 | $11.22 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $8.91 | Facility | None | $4.68 | $4.68 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Pacific Source Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $14.45 | Facility | None | $3.55 | $3.55 | $14.45 |
Premera BCBS Setting Facility Modifier None Typical Low $5.13 Median $9.55 Typical High $21.38 | Facility | None | $5.13 | $9.55 | $21.38 |
Premera BCBS Setting Professional Modifier None Typical Low $3.89 Median $5.13 Typical High $5.13 | Professional | None | $3.89 | $5.13 | $5.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $5.62 Median $6.61 Typical High $11.22 | Facility | None | $5.62 | $6.61 | $11.22 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Wellpoint Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.68 | Professional | None | $3.39 | $3.39 | $4.68 |
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 $1.82 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $1.82 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.72 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.54 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.36 | $0.39 | $0.39 |
Where Washington sits
The same service costs 4.0 times more in Oklahoma 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· 19th of 51
$3.89
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.