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 $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.31 Typical High $4.27 | Professional | None | $3.02 | $3.31 | $4.27 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.02 Median $8.13 Typical High $11.48 | Facility | None | $3.02 | $8.13 | $11.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $11.22 | Facility | None | $3.98 | $3.98 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Pacific Source Setting Facility Modifier None Typical Low $4.68 Median $5.37 Typical High $7.08 | Facility | None | $4.68 | $5.37 | $7.08 |
Premera BCBS Setting Facility Modifier None Typical Low $5.25 Median $8.13 Typical High $19.50 | Facility | None | $5.25 | $8.13 | $19.50 |
Premera BCBS Setting Professional Modifier None Typical Low $4.17 Median $5.50 Typical High $5.50 | Professional | None | $4.17 | $5.50 | $5.50 |
Regence BlueShield Setting Facility Modifier None Typical Low $6.92 Median $8.13 Typical High $11.48 | Facility | None | $6.92 | $8.13 | $11.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Wellpoint Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.98 | Professional | None | $3.63 | $3.63 | $3.98 |
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 $1.55 Median $1.66 Typical High $1.66 | Professional | 52 · Reduced service | $1.55 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.62 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.46 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.31 | $0.33 | $0.33 |
Where Washington sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 18th of 51
$3.63
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.