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 $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.29 Typical High $2.29 | Professional | None | $2.09 | $2.29 | $2.29 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.82 Median $2.09 Typical High $2.88 | Facility | None | $1.82 | $2.09 | $2.88 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Cigna Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $4.07 | Facility | None | $2.75 | $2.75 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Pacific Source Setting Facility Modifier None Typical Low $1.95 Median $2.45 Typical High $4.07 | Facility | None | $1.95 | $2.45 | $4.07 |
Premera BCBS Setting Facility Modifier None Typical Low $1.58 Median $1.82 Typical High $5.01 | Facility | None | $1.58 | $1.82 | $5.01 |
Premera BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.82 Median $2.09 Typical High $2.88 | Facility | None | $1.82 | $2.09 | $2.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
United Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Wellpoint Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.69 | Professional | None | $1.95 | $1.95 | $2.69 |
5 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 $1.05 Median $1.15 Typical High $1.15 | Professional | 52 · Reduced service | $1.05 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.46 Typical High $0.46 | Professional | 53 · Discontinued | $0.42 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.58 Median $1.74 Typical High $1.74 | Professional | 54 · Surgery only | $1.58 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.34 Typical High $0.34 | Professional | 55 · Aftercare only | $0.32 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.21 | $0.23 | $0.23 |
Where Washington sits
The same service costs 1.6 times more in Alaska than in Iowa. 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· 44th of 51
$2.09
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.