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 $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.98 | Professional | None | $3.09 | $3.09 | $3.98 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $30.20 | Facility | None | $4.17 | $4.17 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $4.68 Median $45.71 Typical High $87.10 | Professional | None | $4.68 | $45.71 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.13 Median $6.92 Typical High $13.49 | Professional | None | $5.13 | $6.92 | $13.49 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $6.03 | Professional | None | $5.37 | $5.89 | $6.03 |
Pacific Source Setting Facility Modifier None Typical Low $4.68 Median $5.25 Typical High $5.37 | Facility | None | $4.68 | $5.25 | $5.37 |
Premera BCBS Setting Facility Modifier None Typical Low $6.61 Median $10.23 Typical High $14.45 | Facility | None | $6.61 | $10.23 | $14.45 |
Premera BCBS Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $5.75 | Professional | None | $4.47 | $4.68 | $5.75 |
United Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $4.37 | Professional | None | $2.29 | $2.29 | $4.37 |
Wellpoint Setting Professional Modifier None Typical Low $4.68 Median $5.50 Typical High $8.32 | Professional | None | $4.68 | $5.50 | $8.32 |
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 $1.55 Median $1.55 Typical High $2.00 | Professional | 52 · Reduced service | $1.55 | $1.55 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.79 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.29 Median $2.29 Typical High $3.02 | Professional | 54 · Surgery only | $2.29 | $2.29 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.60 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.40 |
Where Washington sits
The same service costs 3.8 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· 16th of 51
$4.47
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.