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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $12.88 | Professional | None | $10.23 | $10.23 | $12.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $30.20 | Facility | None | $13.80 | $13.80 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $15.49 Median $138.04 Typical High $158.49 | Professional | None | $15.49 | $138.04 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.38 Median $22.91 Typical High $40.74 | Professional | None | $17.38 | $22.91 | $40.74 |
Molina Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $20.42 | Professional | None | $18.20 | $19.95 | $20.42 |
Pacific Source Setting Facility Modifier None Typical Low $16.22 Median $17.78 Typical High $19.05 | Facility | None | $16.22 | $17.78 | $19.05 |
Premera BCBS Setting Facility Modifier None Typical Low $21.88 Median $34.67 Typical High $48.98 | Facility | None | $21.88 | $34.67 | $48.98 |
Premera BCBS Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Regence BlueShield Setting Professional Modifier None Typical Low $14.79 Median $15.49 Typical High $19.50 | Professional | None | $14.79 | $15.49 | $19.50 |
United Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $14.45 | Professional | None | $7.59 | $7.59 | $14.45 |
Wellpoint Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $27.54 | Professional | None | $15.49 | $18.20 | $27.54 |
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 $5.13 Median $5.13 Typical High $6.46 | Professional | 52 · Reduced service | $5.13 | $5.13 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $2.57 | Professional | 53 · Discontinued | $2.04 | $2.04 | $2.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $7.76 Typical High $9.77 | Professional | 54 · Surgery only | $7.76 | $7.76 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $1.82 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.02 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.02 | $1.02 | $1.23 |
Where Washington sits
The same service costs 2.7 times more in Idaho 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· 14th of 51
$15.14
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.