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 $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.74 Typical High $1.74 | Professional | None | $1.58 | $1.74 | $1.74 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.29 Median $1.95 Typical High $2.69 | Facility | None | $1.29 | $1.95 | $2.69 |
Cigna Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $3.16 | Facility | None | $2.09 | $2.09 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Pacific Source Setting Facility Modifier None Typical Low $1.62 Median $2.51 Typical High $2.75 | Facility | None | $1.62 | $2.51 | $2.75 |
Premera BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.66 Typical High $4.27 | Facility | None | $1.35 | $1.66 | $4.27 |
Premera BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.86 Typical High $1.86 | Professional | None | $1.82 | $1.86 | $1.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.29 Median $1.86 Typical High $2.45 | Facility | None | $1.29 | $1.86 | $2.45 |
United Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Wellpoint Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.04 | Professional | None | $1.58 | $1.58 | $2.04 |
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 $0.79 Median $0.87 Typical High $0.87 | Professional | 52 · Reduced service | $0.79 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.35 Typical High $0.35 | Professional | 53 · Discontinued | $0.32 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.26 Typical High $0.26 | Professional | 55 · Aftercare only | $0.24 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.17 |
Where Washington sits
The same service costs 1.7 times more in Arizona than in Alabama. 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· 17th of 51
$1.66
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.