How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $1Professionalmedian $1 · 10th to 90th $0 to $2
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 $0.48 Median $0.48 Typical High $0.48 | Facility | None | $0.48 | $0.48 | $0.48 |
Aetna Setting Professional Modifier None Typical Low $0.45 Median $0.48 Typical High $0.48 | Professional | None | $0.45 | $0.48 | $0.48 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.52 Median $0.71 Typical High $0.72 | Facility | None | $0.52 | $0.71 | $0.72 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.65 Median $3.89 Typical High $5.62 | Professional | None | $0.65 | $3.89 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.45 | Facility | None | $0.42 | $0.42 | $0.45 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Kaiser Permanente Setting Facility Modifier None Typical Low $0.68 Median $0.91 Typical High $1.82 | Facility | None | $0.68 | $0.91 | $1.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.65 Median $0.91 Typical High $1.82 | Professional | None | $0.65 | $0.91 | $1.82 |
Molina Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $60.26 | Professional | None | $0.72 | $0.72 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $0.72 Median $0.74 Typical High $0.78 | Facility | None | $0.72 | $0.74 | $0.78 |
Premera BCBS Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $1.45 | Facility | None | $0.65 | $0.65 | $1.45 |
Premera BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.72 | Professional | None | $0.62 | $0.62 | $0.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Facility | None | $0.72 | $0.72 | $0.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.62 Median $0.65 Typical High $0.79 | Professional | None | $0.62 | $0.65 | $0.79 |
United Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.66 | Professional | None | $0.34 | $0.34 | $0.66 |
Wellpoint Setting Professional Modifier None Typical Low $0.52 Median $0.62 Typical High $1.12 | Professional | None | $0.52 | $0.62 | $1.12 |
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 $0.23 Median $0.24 Typical High $0.24 | Professional | 52 · Reduced service | $0.23 | $0.24 | $0.24 |
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 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | NR · New when rented | $0.65 | $0.65 | $0.65 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $0.62 Median $0.62 Typical High $0.72 | Professional | NR · New when rented | $0.62 | $0.62 | $0.72 |
Where Washington sits
The same service costs 2.3 times more in Montana than in Hawaii. 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
$0.65
MT $0.81HI $0.35
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.