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 $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.91 Typical High $1.91 | Professional | None | $1.74 | $1.91 | $1.91 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.41 Median $2.09 Typical High $2.82 | Facility | None | $1.41 | $2.09 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $3.39 | Facility | None | $2.29 | $2.29 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Pacific Source Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Premera BCBS Setting Facility Modifier None Typical Low $1.45 Median $1.70 Typical High $4.57 | Facility | None | $1.45 | $1.70 | $4.57 |
Premera BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.41 Median $1.95 Typical High $2.57 | Facility | None | $1.41 | $1.95 | $2.57 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Wellpoint Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.24 | Professional | None | $1.74 | $1.74 | $2.24 |
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 $0.87 Median $0.95 Typical High $0.95 | Professional | 52 · Reduced service | $0.87 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.38 Typical High $0.38 | Professional | 53 · Discontinued | $0.35 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.26 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.17 | $0.19 | $0.19 |
Where Washington sits
The same service costs 1.8 times more in Alaska than in Virginia. 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· 28th of 51
$1.74
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.