How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $12.59 Typical High $14.45 | Professional | None | $10.47 | $12.59 | $14.45 |
Ambetter Setting Professional Modifier None Typical Low $11.48 Median $23.99 Typical High $26.30 | Professional | None | $11.48 | $23.99 | $26.30 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $10.72 Median $13.49 Typical High $24.55 | Facility | None | $10.72 | $13.49 | $24.55 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | None | $89.13 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $23.44 | Facility | None | $20.89 | $20.89 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.85 | Professional | None | $15.49 | $15.49 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $26.30 Typical High $33.11 | Professional | None | $12.88 | $26.30 | $33.11 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $75.86 | Professional | None | $44.67 | $50.12 | $75.86 |
Pacific Source Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $120.23 | Facility | None | $20.42 | $24.55 | $120.23 |
Premera BCBS Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | NR · New when rented | $16.60 | $16.60 | $16.60 |
Premera BCBS Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | NR · New when rented | $16.98 | $16.98 | $16.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $17.38 Median $18.62 Typical High $26.92 | Facility | None | $17.38 | $18.62 | $26.92 |
United Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $13.49 | Professional | None | $7.94 | $7.94 | $13.49 |
Wellpoint Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
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 $4.90 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $4.90 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.00 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.48 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.26 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.00 | $1.26 | $1.26 |
Where Washington sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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
$16.22
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.