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 $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.09 | Professional | None | $2.40 | $2.40 | $3.09 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $30.20 | Facility | None | $3.24 | $3.24 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3.63 Median $38.02 Typical High $72.44 | Professional | None | $3.63 | $38.02 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.98 Median $5.37 Typical High $10.72 | Professional | None | $3.98 | $5.37 | $10.72 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $4.79 | Professional | None | $4.27 | $4.68 | $4.79 |
Pacific Source Setting Facility Modifier None Typical Low $4.17 Median $4.27 Typical High $4.27 | Facility | None | $4.17 | $4.27 | $4.27 |
Premera BCBS Setting Facility Modifier None Typical Low $5.13 Median $8.13 Typical High $11.48 | Facility | None | $5.13 | $8.13 | $11.48 |
Premera BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.47 Median $3.63 Typical High $4.57 | Professional | None | $3.47 | $3.63 | $4.57 |
United Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $3.47 | Professional | None | $1.78 | $1.78 | $3.47 |
Wellpoint Setting Professional Modifier None Typical Low $3.63 Median $4.27 Typical High $6.46 | Professional | None | $3.63 | $4.27 | $6.46 |
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 $1.20 Median $1.20 Typical High $1.55 | Professional | 52 · Reduced service | $1.20 | $1.20 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.48 Median $0.48 Typical High $0.62 | Professional | 53 · Discontinued | $0.48 | $0.48 | $0.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.82 Median $1.82 Typical High $2.34 | Professional | 54 · Surgery only | $1.82 | $1.82 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.36 Median $0.36 Typical High $0.47 | Professional | 55 · Aftercare only | $0.36 | $0.36 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.24 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.24 | $0.24 | $0.31 |
Where Washington sits
The same service costs 4.0 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· 15th of 51
$3.55
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.