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 $2.34 Median $2.34 Typical High $2.63 | Facility | None | $2.34 | $2.34 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $2.57 | Professional | None | $2.14 | $2.34 | $2.57 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.34 | Facility | None | $2.14 | $2.14 | $2.34 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $2.34 | Professional | None | $2.14 | $2.34 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $5.75 | Facility | None | $3.24 | $3.24 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.09 Median $2.63 Typical High $3.98 | Professional | None | $2.09 | $2.63 | $3.98 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.57 | Professional | None | $2.34 | $2.34 | $2.57 |
Pacific Source Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $6.92 | Facility | None | $2.29 | $2.29 | $6.92 |
Premera BCBS Setting Facility Modifier None Typical Low $3.16 Median $4.07 Typical High $4.07 | Facility | None | $3.16 | $4.07 | $4.07 |
Premera BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Regence BlueShield Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | None | $2.34 | $2.34 | $2.34 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $2.34 | Professional | None | $2.14 | $2.34 | $2.34 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.29 | Professional | None | $2.19 | $2.19 | $2.29 |
Wellpoint Setting Professional Modifier None Typical Low $2.09 Median $2.14 Typical High $2.75 | Professional | None | $2.09 | $2.14 | $2.75 |
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 $1.07 Median $1.17 Typical High $1.17 | Professional | 52 · Reduced service | $1.07 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.47 Typical High $0.47 | Professional | 53 · Discontinued | $0.43 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.35 Typical High $0.35 | Professional | 55 · Aftercare only | $0.32 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.21 | $0.23 | $0.23 |
Where Washington sits
The same service costs 1.9 times more in Wyoming than in Maine. 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· 8th of 51
$2.34
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.