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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $3.55 | Professional | None | $3.24 | $3.55 | $3.55 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.24 Median $4.79 Typical High $5.62 | Facility | None | $3.24 | $4.79 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $6.46 | Facility | None | $4.27 | $4.27 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Pacific Source Setting Facility Modifier None Typical Low $3.24 Median $3.63 Typical High $4.79 | Facility | None | $3.24 | $3.63 | $4.79 |
Premera BCBS Setting Facility Modifier None Typical Low $2.75 Median $3.24 Typical High $9.12 | Facility | None | $2.75 | $3.24 | $9.12 |
Premera BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Regence BlueShield Setting Facility Modifier None Typical Low $3.24 Median $4.17 Typical High $5.25 | Facility | None | $3.24 | $4.17 | $5.25 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Wellpoint Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.17 | Professional | None | $3.24 | $3.24 | $4.17 |
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 $1.62 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.62 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.65 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.69 Typical High $2.69 | Professional | 54 · Surgery only | $2.45 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.49 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.33 | $0.36 | $0.36 |
Where Washington sits
The same service costs 1.7 times more in Arizona 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· 19th of 51
$3.39
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.