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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.03 | Professional | None | $4.57 | $4.57 | $6.03 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $30.20 | Facility | None | $6.17 | $6.17 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $7.08 Median $61.66 Typical High $112.20 | Professional | None | $7.08 | $61.66 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $10.47 Typical High $19.95 | Professional | None | $7.76 | $10.47 | $19.95 |
Molina Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $9.12 | Professional | None | $8.13 | $8.91 | $9.12 |
Pacific Source Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $8.13 | Facility | None | $7.94 | $7.94 | $8.13 |
Premera BCBS Setting Facility Modifier None Typical Low $9.77 Median $15.49 Typical High $21.88 | Facility | None | $9.77 | $15.49 | $21.88 |
Premera BCBS Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.61 Median $7.08 Typical High $8.71 | Professional | None | $6.61 | $7.08 | $8.71 |
United Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $6.61 | Professional | None | $3.47 | $3.47 | $6.61 |
Wellpoint Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $12.30 | Professional | None | $7.08 | $8.32 | $12.30 |
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 $2.29 Median $2.29 Typical High $3.02 | Professional | 52 · Reduced service | $2.29 | $2.29 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $1.20 | Professional | 53 · Discontinued | $0.91 | $0.91 | $1.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.47 Median $3.47 Typical High $4.47 | Professional | 54 · Surgery only | $3.47 | $3.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.69 Typical High $0.89 | Professional | 55 · Aftercare only | $0.69 | $0.69 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.46 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.46 | $0.46 | $0.60 |
Where Washington sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 17th of 51
$6.76
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.