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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.77 | Professional | None | $9.55 | $9.55 | $9.77 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $7.94 Median $11.75 Typical High $20.42 | Facility | None | $7.94 | $11.75 | $20.42 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $1.70 Typical High $3.09 | Facility | None | $1.58 | $1.70 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $9.55 | Professional | None | $6.46 | $6.46 | $9.55 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Pacific Source Setting Facility Modifier None Typical Low $16.98 Median $20.89 Typical High $20.89 | Facility | None | $16.98 | $20.89 | $20.89 |
Premera BCBS Setting Facility Modifier None Typical Low $11.22 Median $19.50 Typical High $30.90 | Facility | None | $11.22 | $19.50 | $30.90 |
Premera BCBS Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $14.13 Median $15.49 Typical High $20.42 | Facility | None | $14.13 | $15.49 | $20.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | None | $11.75 | $12.59 | $12.59 |
United Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $36.31 | Professional | None | $12.02 | $14.13 | $36.31 |
Wellpoint Setting Professional Modifier None Typical Low $5.62 Median $12.59 Typical High $22.39 | Professional | None | $5.62 | $12.59 | $22.39 |
5 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 $4.79 Median $4.79 Typical High $4.90 | Professional | 52 · Reduced service | $4.79 | $4.79 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $1.95 | Professional | 53 · Discontinued | $1.91 | $1.91 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.41 Typical High $1.48 | Professional | 55 · Aftercare only | $1.41 | $1.41 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $0.98 |
Premera BCBS Setting Facility Modifier LR · Lab round trip Typical Low $12.59 Median $19.95 Typical High $30.90 | Facility | LR · Lab round trip | $12.59 | $19.95 | $30.90 |
Where Washington sits
The same service costs 25.1 times more in Wyoming than in New Jersey. 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· 6th of 51
$14.13
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.