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 $0.20 Median $0.22 Typical High $0.35 | Facility | None | $0.20 | $0.22 | $0.35 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.22 Typical High $0.34 | Professional | None | $0.20 | $0.22 | $0.34 |
Ambetter Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Facility | None | $0.20 | $0.20 | $0.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.23 | Professional | None | $0.20 | $0.20 | $0.23 |
Cigna Setting Facility Modifier None Typical Low $0.27 Median $0.27 Typical High $0.40 | Facility | None | $0.27 | $0.27 | $0.40 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.23 | Professional | None | $0.20 | $0.20 | $0.23 |
Molina Setting Professional Modifier None Typical Low $0.15 Median $0.20 Typical High $0.39 | Professional | None | $0.15 | $0.20 | $0.39 |
Premera BCBS Setting Facility Modifier None Typical Low $0.30 Median $0.40 Typical High $0.40 | Facility | None | $0.30 | $0.40 | $0.40 |
Premera BCBS Setting Professional Modifier None Typical Low $0.23 Median $0.30 Typical High $0.30 | Professional | None | $0.23 | $0.30 | $0.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Facility | None | $0.20 | $0.20 | $0.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.23 | Professional | None | $0.20 | $0.20 | $0.23 |
United Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | None | $0.21 | $0.21 | $0.21 |
Wellpoint Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.26 | Professional | None | $0.20 | $0.20 | $0.26 |
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 $0.11 Median $0.11 Typical High $0.11 | Professional | 52 · Reduced service | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Washington sits
The same service costs 2.3 times more in Oklahoma than in Florida. 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· 35th of 51
$0.21
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.