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 $0.49 Median $0.49 Typical High $0.56 | Facility | None | $0.49 | $0.49 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.44 Median $0.49 Typical High $0.79 | Professional | None | $0.44 | $0.49 | $0.79 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.44 Median $0.45 Typical High $0.45 | Facility | None | $0.44 | $0.45 | $0.45 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.51 | Professional | None | $0.44 | $0.44 | $0.51 |
Cigna Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $0.87 | Facility | None | $0.59 | $0.59 | $0.87 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.45 | Professional | None | $0.44 | $0.44 | $0.45 |
Molina Setting Professional Modifier None Typical Low $0.33 Median $0.44 Typical High $0.81 | Professional | None | $0.33 | $0.44 | $0.81 |
Pacific Source Setting Facility Modifier None Typical Low $0.39 Median $0.39 Typical High $1.17 | Facility | None | $0.39 | $0.39 | $1.17 |
Premera BCBS Setting Facility Modifier None Typical Low $0.47 Median $0.52 Typical High $0.52 | Facility | None | $0.47 | $0.52 | $0.52 |
Premera BCBS Setting Professional Modifier None Typical Low $0.46 Median $0.47 Typical High $0.47 | Professional | None | $0.46 | $0.47 | $0.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Facility | None | $0.44 | $0.44 | $0.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.51 | Professional | None | $0.44 | $0.44 | $0.51 |
United Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | None | $0.44 | $0.44 | $0.44 |
Wellpoint Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.56 | Professional | None | $0.40 | $0.40 | $0.56 |
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 $0.23 Median $0.25 Typical High $0.25 | Professional | 52 · Reduced service | $0.23 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.10 Typical High $0.10 | Professional | 53 · Discontinued | $0.09 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Washington sits
The same service costs 1.6 times more in Alaska than in Montana. 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· 44th of 51
$0.44
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.