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 $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $2.40 Typical High $2.40 | Professional | None | $2.24 | $2.40 | $2.40 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $2.19 Median $2.82 Typical High $3.98 | Facility | None | $2.19 | $2.82 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $4.79 | Facility | None | $2.88 | $2.88 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Pacific Source Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $7.08 | Facility | None | $2.34 | $2.34 | $7.08 |
Premera BCBS Setting Facility Modifier None Typical Low $2.00 Median $2.34 Typical High $5.62 | Facility | None | $2.00 | $2.34 | $5.62 |
Premera BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.75 Typical High $2.75 | Professional | None | $2.69 | $2.75 | $2.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $2.29 Median $2.69 Typical High $3.89 | Facility | None | $2.29 | $2.69 | $3.89 |
United Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Wellpoint Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.82 | Professional | None | $2.34 | $2.34 | $2.82 |
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 $1.12 Median $1.20 Typical High $1.20 | Professional | 52 · Reduced service | $1.12 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.48 Typical High $0.48 | Professional | 53 · Discontinued | $0.44 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.36 Typical High $0.36 | Professional | 55 · Aftercare only | $0.33 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.24 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.22 | $0.24 | $0.24 |
Where Washington sits
The same service costs 1.9 times more in Alaska than in New York. 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· 20th of 51
$2.40
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.