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 $0.34 Median $0.34 Typical High $0.56 | Facility | None | $0.34 | $0.34 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.35 Typical High $0.44 | Professional | None | $0.32 | $0.35 | $0.44 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $0.32 Median $0.42 Typical High $0.69 | Facility | None | $0.32 | $0.42 | $0.69 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | None | $0.32 | $0.32 | $0.32 |
Cigna Setting Facility Modifier None Typical Low $0.28 Median $0.40 Typical High $0.62 | Facility | None | $0.28 | $0.40 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | None | $0.32 | $0.32 | $0.32 |
Pacific Source Setting Facility Modifier None Typical Low $0.30 Median $0.44 Typical High $0.48 | Facility | None | $0.30 | $0.44 | $0.48 |
Premera BCBS Setting Facility Modifier None Typical Low $0.26 Median $0.34 Typical High $0.93 | Facility | None | $0.26 | $0.34 | $0.93 |
Premera BCBS Setting Professional Modifier None Typical Low $0.32 Median $0.42 Typical High $0.42 | Professional | None | $0.32 | $0.42 | $0.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.28 Median $0.42 Typical High $0.69 | Facility | None | $0.28 | $0.42 | $0.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | None | $0.32 | $0.32 | $0.32 |
United Setting Facility Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.31 | Professional | None | $0.28 | $0.28 | $0.31 |
Wellpoint Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.42 | Professional | None | $0.28 | $0.28 | $0.42 |
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 $0.17 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Where Washington sits
The same service costs 2.8 times more in Texas than in Rhode Island. 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· 38th of 51
$0.32
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.