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 $2.40 Median $2.40 Typical High $2.51 | Facility | None | $2.40 | $2.40 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $3.31 | Professional | None | $2.19 | $2.40 | $3.31 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $4.37 | Facility | None | $2.88 | $2.88 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Pacific Source Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.40 | Facility | None | $2.04 | $2.04 | $2.40 |
Premera BCBS Setting Facility Modifier None Typical Low $2.63 Median $4.07 Typical High $4.07 | Facility | None | $2.63 | $4.07 | $4.07 |
Premera BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.63 Typical High $2.63 | Professional | None | $2.51 | $2.63 | $2.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Wellpoint Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.88 | Professional | None | $2.19 | $2.19 | $2.88 |
3 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 55 · Aftercare only Typical Low $0.33 Median $0.36 Typical High $0.36 | Professional | 55 · Aftercare only | $0.33 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.24 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.22 | $0.24 | $0.24 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | JZ · No drug discarded | $2.88 | $2.88 | $2.88 |
Where Washington sits
The same service costs 1.9 times more in Wyoming than in South Carolina. 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· 32nd of 51
$2.40
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.