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 $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.55 Typical High $1.55 | Professional | None | $1.41 | $1.55 | $1.55 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.12 Median $1.70 Typical High $2.45 | Facility | None | $1.12 | $1.70 | $2.45 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.75 | Facility | None | $1.86 | $1.86 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Premera BCBS Setting Facility Modifier None Typical Low $1.17 Median $1.51 Typical High $3.72 | Facility | None | $1.17 | $1.51 | $3.72 |
Premera BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.62 Typical High $1.62 | Professional | None | $1.58 | $1.62 | $1.62 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.12 Median $1.66 Typical High $2.24 | Facility | None | $1.12 | $1.66 | $2.24 |
United Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Wellpoint Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.82 | Professional | None | $1.38 | $1.38 | $1.82 |
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 $0.71 Median $0.78 Typical High $0.78 | Professional | 52 · Reduced service | $0.71 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.31 Typical High $0.31 | Professional | 53 · Discontinued | $0.28 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.21 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.14 | $0.15 | $0.15 |
Where Washington sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 15th of 51
$1.51
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.