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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $6.61 | Professional | None | $4.79 | $4.79 | $6.61 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | None | $8.51 | $8.51 | $8.91 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $30.20 | Facility | None | $6.46 | $6.46 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $7.24 Median $74.13 Typical High $144.54 | Professional | None | $7.24 | $74.13 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.13 Median $10.72 Typical High $21.38 | Professional | None | $8.13 | $10.72 | $21.38 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $9.55 | Professional | None | $8.51 | $9.33 | $9.55 |
Pacific Source Setting Facility Modifier None Typical Low $7.41 Median $8.13 Typical High $8.51 | Facility | None | $7.41 | $8.13 | $8.51 |
Premera BCBS Setting Facility Modifier None Typical Low $10.23 Median $15.85 Typical High $22.39 | Facility | None | $10.23 | $15.85 | $22.39 |
Premera BCBS Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.92 Median $7.24 Typical High $9.12 | Professional | None | $6.92 | $7.24 | $9.12 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.76 | Professional | None | $3.55 | $3.55 | $6.76 |
Wellpoint Setting Professional Modifier None Typical Low $7.24 Median $8.51 Typical High $12.88 | Professional | None | $7.24 | $8.51 | $12.88 |
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 $2.40 Median $2.40 Typical High $3.09 | Professional | 52 · Reduced service | $2.40 | $2.40 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $1.23 | Professional | 53 · Discontinued | $0.95 | $0.95 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.63 Median $3.63 Typical High $4.68 | Professional | 54 · Surgery only | $3.63 | $3.63 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.93 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.62 |
Where Washington sits
The same service costs 4.1 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· 19th of 51
$6.92
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.