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 $6.17 Median $6.17 Typical High $6.92 | Facility | None | $6.17 | $6.17 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $6.17 Typical High $6.17 | Professional | None | $5.62 | $6.17 | $6.17 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $10.96 | Facility | None | $7.41 | $7.41 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Premera BCBS Setting Facility Modifier None Typical Low $10.72 Median $16.22 Typical High $16.22 | Facility | None | $10.72 | $16.22 | $16.22 |
Premera BCBS Setting Professional Modifier None Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | None | $10.47 | $10.72 | $10.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Wellpoint Setting Professional Modifier None Typical Low $7.24 Median $9.12 Typical High $9.12 | Professional | None | $7.24 | $9.12 | $9.12 |
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 $2.82 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.82 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.12 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.85 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.56 | $0.62 | $0.62 |
Where Washington sits
The same service costs 3.2 times more in Oklahoma than in North Dakota. 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
$6.17
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.