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 $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $5.13 Typical High $5.13 | Professional | None | $4.68 | $5.13 | $5.13 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.98 Median $5.75 Typical High $7.94 | Facility | None | $3.98 | $5.75 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $9.33 | Facility | None | $6.17 | $6.17 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Premera BCBS Setting Facility Modifier None Typical Low $3.89 Median $4.37 Typical High $12.30 | Facility | None | $3.89 | $4.37 | $12.30 |
Premera BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | None | $5.25 | $5.37 | $5.37 |
Regence BlueShield Setting Facility Modifier None Typical Low $3.98 Median $5.37 Typical High $7.24 | Facility | None | $3.98 | $5.37 | $7.24 |
United Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Wellpoint Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.03 | Professional | None | $4.57 | $4.57 | $6.03 |
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 $2.34 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $2.34 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $0.93 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.71 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.47 | $0.51 | $0.51 |
Where Washington sits
The same service costs 1.9 times more in Alaska 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· 38th of 51
$4.68
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.