How much rates vary
Facilitymedian $6 · 10th to 90th $5 to $10Professionalmedian $5 · 10th to 90th $3 to $15
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 $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.98 Typical High $3.98 | Professional | None | $3.72 | $3.98 | $3.98 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $4.79 Median $5.89 Typical High $6.46 | Facility | None | $4.79 | $5.89 | $6.46 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $5.25 Median $32.36 Typical High $46.77 | Professional | None | $5.25 | $32.36 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.80 | Facility | None | $3.55 | $3.55 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Kaiser Permanente Setting Facility Modifier None Typical Low $5.89 Median $7.41 Typical High $10.96 | Facility | None | $5.89 | $7.41 | $10.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.62 Median $7.59 Typical High $12.59 | Professional | None | $5.62 | $7.59 | $12.59 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $60.26 Typical High $60.26 | Professional | None | $6.31 | $60.26 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $6.03 Median $6.17 Typical High $6.31 | Facility | None | $6.03 | $6.17 | $6.31 |
Premera BCBS Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $12.02 | Facility | None | $5.37 | $5.37 | $12.02 |
Premera BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.89 | Professional | None | $5.13 | $5.13 | $5.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.01 Median $5.25 Typical High $6.61 | Professional | None | $5.01 | $5.25 | $6.61 |
United Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
United Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $5.50 | Professional | None | $2.82 | $2.82 | $5.50 |
Wellpoint Setting Professional Modifier None Typical Low $3.55 Median $4.37 Typical High $9.33 | Professional | None | $3.55 | $4.37 | $9.33 |
6 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 $1.86 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $1.86 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.74 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.56 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.37 | $0.40 | $0.40 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | NR · New when rented | $5.37 | $5.37 | $5.37 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $5.13 Median $5.13 Typical High $5.89 | Professional | NR · New when rented | $5.13 | $5.13 | $5.89 |
Where Washington sits
The same service costs 4.9 times more in Kansas than in Delaware. 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· 13th of 51
$5.37
KS $14.45DE $2.95
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.