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 $0.40 Median $0.40 Typical High $0.45 | Facility | None | $0.40 | $0.40 | $0.45 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.41 Typical High $0.79 | Professional | None | $0.36 | $0.41 | $0.79 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.37 Median $0.50 Typical High $0.71 | Facility | None | $0.37 | $0.50 | $0.71 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Cigna Setting Facility Modifier None Typical Low $0.49 Median $0.49 Typical High $0.72 | Facility | None | $0.49 | $0.49 | $0.72 |
Cigna Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Premera BCBS Setting Facility Modifier None Typical Low $0.32 Median $0.46 Typical High $1.26 | Facility | None | $0.32 | $0.46 | $1.26 |
Premera BCBS Setting Professional Modifier None Typical Low $0.41 Median $0.54 Typical High $0.54 | Professional | None | $0.41 | $0.54 | $0.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.33 Median $0.50 Typical High $0.66 | Facility | None | $0.33 | $0.50 | $0.66 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
United Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Facility | None | $0.37 | $0.37 | $0.37 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | None | $0.23 | $0.23 | $0.23 |
Wellpoint Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.48 | Professional | None | $0.36 | $0.36 | $0.48 |
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 $0.19 Median $0.21 Typical High $0.21 | Professional | 52 · Reduced service | $0.19 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.07 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Washington sits
The same service costs 7.8 times more in Texas than in Maryland. 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
$0.40
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.