How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $2.04 Typical High $2.04 | Professional | None | $1.86 | $2.04 | $2.04 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $3.72 | Facility | None | $2.45 | $2.45 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.78 Median $2.24 Typical High $3.47 | Professional | None | $1.78 | $2.24 | $3.47 |
Pacific Source Setting Facility Modifier None Typical Low $1.82 Median $2.04 Typical High $2.75 | Facility | None | $1.82 | $2.04 | $2.75 |
Premera BCBS Setting Facility Modifier None Typical Low $1.78 Median $1.78 Typical High $2.00 | Facility | None | $1.78 | $1.78 | $2.00 |
Premera BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Wellpoint Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.40 | Professional | None | $1.86 | $1.86 | $2.40 |
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 $0.93 Median $1.02 Typical High $1.02 | Professional | 52 · Reduced service | $0.93 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.41 Typical High $0.41 | Professional | 53 · Discontinued | $0.37 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.28 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.19 | $0.21 | $0.21 |
Where Washington sits
Rates are fairly even across states for this service. 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· 37th of 51
$1.86
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.