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 $5.75 Median $5.75 Typical High $6.46 | Facility | None | $5.75 | $5.75 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $5.89 | Professional | None | $5.25 | $5.75 | $5.89 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $5.25 Median $10.47 Typical High $15.14 | Facility | None | $5.25 | $10.47 | $15.14 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | None | $5.25 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $7.94 Typical High $10.47 | Facility | None | $5.75 | $7.94 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.13 Median $6.46 Typical High $9.77 | Professional | None | $5.13 | $6.46 | $9.77 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $5.75 Typical High $6.61 | Professional | None | $5.37 | $5.75 | $6.61 |
Pacific Source Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Premera BCBS Setting Facility Modifier None Typical Low $8.71 Median $16.22 Typical High $28.84 | Facility | None | $8.71 | $16.22 | $28.84 |
Premera BCBS Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $5.75 Median $10.47 Typical High $15.14 | Facility | None | $5.75 | $10.47 | $15.14 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | None | $5.25 | $5.75 | $5.75 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | None | $4.90 | $4.90 | $5.25 |
Wellpoint Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $6.92 | Professional | None | $5.25 | $5.75 | $6.92 |
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 $2.63 Median $2.88 Typical High $2.88 | Professional | 52 · Reduced service | $2.63 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.15 Typical High $1.15 | Professional | 53 · Discontinued | $1.07 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.79 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.58 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.52 | $0.58 | $0.58 |
Where Washington sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 10th of 51
$5.75
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.