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 $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $2.82 | Professional | None | $2.57 | $2.82 | $2.82 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $2.09 Median $2.82 Typical High $4.07 | Facility | None | $2.09 | $2.82 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $5.13 | Facility | None | $3.39 | $3.39 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Pacific Source Setting Facility Modifier None Typical Low $2.45 Median $3.89 Typical High $4.17 | Facility | None | $2.45 | $3.89 | $4.17 |
Premera BCBS Setting Facility Modifier None Typical Low $2.00 Median $2.34 Typical High $6.17 | Facility | None | $2.00 | $2.34 | $6.17 |
Premera BCBS Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $2.09 Median $2.75 Typical High $3.72 | Facility | None | $2.09 | $2.75 | $3.72 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Wellpoint Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.39 | Professional | None | $2.45 | $2.45 | $3.39 |
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 $1.29 Median $1.41 Typical High $1.41 | Professional | 52 · Reduced service | $1.29 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.56 Typical High $0.56 | Professional | 53 · Discontinued | $0.52 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $2.14 Typical High $2.14 | Professional | 54 · Surgery only | $1.95 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.39 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.26 | $0.28 | $0.28 |
Where Washington sits
The same service costs 1.8 times more in Alaska than in Maryland. 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· 42nd of 51
$2.57
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.