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 $12.59 Median $12.59 Typical High $14.13 | Facility | None | $12.59 | $12.59 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $12.59 Typical High $16.98 | Professional | None | $11.22 | $12.59 | $16.98 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $11.48 Median $14.79 Typical High $20.42 | Facility | None | $11.48 | $14.79 | $20.42 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $25.70 | Facility | None | $15.14 | $15.14 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Pacific Source Setting Facility Modifier None Typical Low $11.75 Median $12.88 Typical High $38.90 | Facility | None | $11.75 | $12.88 | $38.90 |
Premera BCBS Setting Facility Modifier None Typical Low $11.22 Median $13.18 Typical High $35.48 | Facility | None | $11.22 | $13.18 | $35.48 |
Premera BCBS Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $12.02 Median $14.79 Typical High $20.42 | Facility | None | $12.02 | $14.79 | $20.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Wellpoint Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $14.79 | Professional | None | $12.59 | $12.59 | $14.79 |
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 $5.75 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $5.75 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.29 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.74 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.26 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.15 | $1.26 | $1.26 |
Where Washington sits
The same service costs 1.8 times more in Alaska than in Georgia. 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· 21st of 51
$12.59
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.