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 $0.39 Median $0.39 Typical High $0.41 | Facility | None | $0.39 | $0.39 | $0.41 |
Aetna Setting Professional Modifier None Typical Low $0.35 Median $0.39 Typical High $0.52 | Professional | None | $0.35 | $0.39 | $0.52 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.28 Median $0.38 Typical High $0.50 | Facility | None | $0.28 | $0.38 | $0.50 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Cigna Setting Facility Modifier None Typical Low $0.35 Median $0.45 Typical High $0.68 | Facility | None | $0.35 | $0.45 | $0.68 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Pacific Source Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
Premera BCBS Setting Facility Modifier None Typical Low $0.31 Median $0.36 Typical High $0.91 | Facility | None | $0.31 | $0.36 | $0.91 |
Premera BCBS Setting Professional Modifier None Typical Low $0.40 Median $0.52 Typical High $0.52 | Professional | None | $0.40 | $0.52 | $0.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.25 Median $0.35 Typical High $0.50 | Facility | None | $0.25 | $0.35 | $0.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
United Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Facility | None | $0.35 | $0.35 | $0.35 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.39 | Professional | None | $0.35 | $0.35 | $0.39 |
Wellpoint Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.46 | Professional | None | $0.35 | $0.35 | $0.46 |
4 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 $0.18 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.18 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.07 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Washington sits
The same service costs 3.0 times more in Texas than in North Dakota. 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· 33rd of 51
$0.37
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.