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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $19.05 | Professional | None | $14.79 | $14.79 | $19.05 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $30.20 | Facility | None | $19.50 | $19.50 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $22.39 Median $199.53 Typical High $380.19 | Professional | None | $22.39 | $199.53 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $63.10 | Professional | None | $24.55 | $33.88 | $63.10 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $28.84 | Professional | None | $25.70 | $28.18 | $28.84 |
Pacific Source Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.70 | Facility | None | $25.12 | $25.12 | $25.70 |
Premera BCBS Setting Facility Modifier None Typical Low $31.62 Median $48.98 Typical High $69.18 | Facility | None | $31.62 | $48.98 | $69.18 |
Premera BCBS Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $27.54 | Professional | None | $21.38 | $22.39 | $27.54 |
United Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $20.89 | Professional | None | $10.96 | $10.96 | $20.89 |
Wellpoint Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $38.90 | Professional | None | $22.39 | $26.30 | $38.90 |
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 $7.41 Median $7.41 Typical High $9.33 | Professional | 52 · Reduced service | $7.41 | $7.41 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $3.72 | Professional | 53 · Discontinued | $2.95 | $2.95 | $3.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $10.96 Typical High $13.80 | Professional | 54 · Surgery only | $10.96 | $10.96 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.69 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $1.78 |
Where Washington sits
The same service costs 3.5 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· 15th of 51
$21.38
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.