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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $5.25 | Professional | None | $4.07 | $4.07 | $5.25 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $30.20 | Facility | None | $5.50 | $5.50 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $6.31 Median $54.95 Typical High $66.07 | Professional | None | $6.31 | $54.95 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $16.60 | Professional | None | $6.92 | $9.12 | $16.60 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $7.94 Typical High $8.13 | Professional | None | $7.24 | $7.94 | $8.13 |
Pacific Source Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.24 | Facility | None | $7.08 | $7.08 | $7.24 |
Premera BCBS Setting Facility Modifier None Typical Low $8.71 Median $13.80 Typical High $19.50 | Facility | None | $8.71 | $13.80 | $19.50 |
Premera BCBS Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $7.76 | Professional | None | $5.89 | $6.31 | $7.76 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $5.89 | Professional | None | $3.09 | $3.09 | $5.89 |
Wellpoint Setting Professional Modifier None Typical Low $6.31 Median $7.41 Typical High $10.96 | Professional | None | $6.31 | $7.41 | $10.96 |
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 $2.04 Median $2.04 Typical High $2.57 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $1.05 | Professional | 53 · Discontinued | $0.81 | $0.81 | $1.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.09 Median $3.09 Typical High $3.89 | Professional | 54 · Surgery only | $3.09 | $3.09 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.72 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.49 |
Where Washington sits
The same service costs 2.7 times more in Hawaii 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
$6.03
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.