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 $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $0.98 | Professional | None | $0.95 | $0.95 | $0.98 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.76 Median $1.10 Typical High $2.00 | Facility | None | $0.76 | $1.10 | $2.00 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Molina Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
Pacific Source Setting Facility Modifier None Typical Low $1.66 Median $2.00 Typical High $2.00 | Facility | None | $1.66 | $2.00 | $2.00 |
Premera BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.95 Typical High $3.09 | Facility | None | $1.35 | $1.95 | $3.09 |
Premera BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.41 Median $1.51 Typical High $2.00 | Facility | None | $1.41 | $1.51 | $2.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $1.20 Median $1.41 Typical High $3.63 | Professional | None | $1.20 | $1.41 | $3.63 |
Wellpoint Setting Professional Modifier None Typical Low $0.56 Median $1.26 Typical High $2.24 | Professional | None | $0.56 | $1.26 | $2.24 |
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 $0.48 Median $0.48 Typical High $0.49 | Professional | 52 · Reduced service | $0.48 | $0.48 | $0.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.19 Typical High $0.20 | Professional | 53 · Discontinued | $0.19 | $0.19 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.15 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where Washington sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 14th of 51
$1.38
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.