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 $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $8.71 | Professional | None | $6.61 | $6.61 | $8.71 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $30.20 | Facility | None | $8.91 | $8.91 | $30.20 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $10.00 Median $89.13 Typical High $144.54 | Professional | None | $10.00 | $89.13 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.22 Median $14.79 Typical High $28.84 | Professional | None | $11.22 | $14.79 | $28.84 |
Molina Setting Professional Modifier None Typical Low $11.75 Median $12.88 Typical High $13.18 | Professional | None | $11.75 | $12.88 | $13.18 |
Pacific Source Setting Facility Modifier None Typical Low $10.47 Median $11.48 Typical High $12.30 | Facility | None | $10.47 | $11.48 | $12.30 |
Premera BCBS Setting Facility Modifier None Typical Low $14.13 Median $22.39 Typical High $31.62 | Facility | None | $14.13 | $22.39 | $31.62 |
Premera BCBS Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Regence BlueShield Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $12.59 | Professional | None | $9.55 | $10.00 | $12.59 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $9.33 | Professional | None | $4.90 | $4.90 | $9.33 |
Wellpoint Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $17.78 | Professional | None | $10.00 | $12.02 | $17.78 |
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 $3.31 Median $3.31 Typical High $4.17 | Professional | 52 · Reduced service | $3.31 | $3.31 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.32 Typical High $1.70 | Professional | 53 · Discontinued | $1.32 | $1.32 | $1.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.01 Median $5.01 Typical High $6.31 | Professional | 54 · Surgery only | $5.01 | $5.01 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.00 Typical High $1.26 | Professional | 55 · Aftercare only | $1.00 | $1.00 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.68 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.68 | $0.68 | $0.81 |
Where Washington sits
The same service costs 2.9 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· 16th of 51
$9.77
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.