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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $13.80 | Professional | None | $8.71 | $8.71 | $13.80 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $29.51 | Professional | None | $20.89 | $26.30 | $29.51 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $30.20 | Facility | None | $11.75 | $11.75 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $13.18 Median $158.49 Typical High $302.00 | Professional | None | $13.18 | $158.49 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.45 Median $19.95 Typical High $38.90 | Professional | None | $14.45 | $19.95 | $38.90 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $16.60 Typical High $16.98 | Professional | None | $15.14 | $16.60 | $16.98 |
Pacific Source Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $15.14 | Facility | None | $14.79 | $14.79 | $15.14 |
Premera BCBS Setting Facility Modifier None Typical Low $18.62 Median $28.84 Typical High $40.74 | Facility | None | $18.62 | $28.84 | $40.74 |
Premera BCBS Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.59 Median $13.18 Typical High $16.22 | Professional | None | $12.59 | $13.18 | $16.22 |
United Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $12.30 | Professional | None | $6.46 | $6.46 | $12.30 |
Wellpoint Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $23.44 | Professional | None | $13.18 | $15.49 | $23.44 |
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 $4.37 Median $4.37 Typical High $5.62 | Professional | 52 · Reduced service | $4.37 | $4.37 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $2.24 | Professional | 53 · Discontinued | $1.74 | $1.74 | $2.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.46 Median $6.46 Typical High $8.32 | Professional | 54 · Surgery only | $6.46 | $6.46 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.70 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $1.12 |
Where Washington sits
The same service costs 4.5 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
$12.59
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.