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 $17.78 Median $17.78 Typical High $19.95 | Facility | None | $17.78 | $17.78 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $23.99 | Professional | None | $16.22 | $17.78 | $23.99 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $16.22 Median $28.84 Typical High $74.13 | Facility | None | $16.22 | $28.84 | $74.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $16.98 Typical High $32.36 | Facility | None | $13.18 | $16.98 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Pacific Source Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Premera BCBS Setting Facility Modifier None Typical Low $19.95 Median $23.44 Typical High $70.79 | Facility | None | $19.95 | $23.44 | $70.79 |
Premera BCBS Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | None | $15.14 | $19.95 | $19.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $19.05 Median $28.84 Typical High $74.13 | Facility | None | $19.05 | $28.84 | $74.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | None | $13.80 | $13.80 | $15.14 |
Wellpoint Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $20.89 | Professional | None | $13.18 | $13.18 | $20.89 |
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 $8.13 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $8.13 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $3.24 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.45 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.62 | $1.78 | $1.78 |
Where Washington sits
The same service costs 5.9 times more in Wyoming 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· 17th of 51
$17.78
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.