How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.35 Median $0.35 Typical High $0.56 | Facility | None | $0.35 | $0.35 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.35 Typical High $0.35 | Professional | None | $0.34 | $0.35 | $0.35 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.50 | Facility | None | $0.35 | $0.35 | $0.50 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $41.69 | Professional | None | $0.50 | $0.50 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $0.35 Median $0.65 Typical High $0.71 | Facility | None | $0.35 | $0.65 | $0.71 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.31 Median $0.52 Typical High $0.81 | Professional | None | $0.31 | $0.52 | $0.81 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $70.79 Typical High $79.43 | Professional | None | $30.20 | $70.79 | $79.43 |
Premera BCBS Setting Facility Modifier None Typical Low $0.34 Median $0.34 Typical High $0.35 | Facility | None | $0.34 | $0.34 | $0.35 |
Premera BCBS Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Facility | None | $0.50 | $0.50 | $0.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None | $0.50 | $0.50 | $0.50 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
Wellpoint Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
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 $0.17 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Where Washington sits
The same service costs 1.6 times more in Montana than in Michigan. 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· 35th of 51
$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.