How much rates vary
Facilitymedian $302 · 10th to 90th $42 to $1,318Professionalmedian $95 · 10th to 90th $27 to $186
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 $27.54 Median $3,548.13 Typical High $20,417.38 | Facility | None | $27.54 | $3,548.13 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $51.29 Typical High $117.49 | Professional | None | $27.54 | $51.29 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $213.80 | Professional | None | $120.23 | $154.88 | $213.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $14.79 Median $537.03 Typical High $1,096.48 | Facility | None | $14.79 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $30.20 Median $114.82 Typical High $691.83 | Professional | None | $30.20 | $114.82 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $75.86 | Facility | None | $50.12 | $52.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $58.88 Typical High $151.36 | Professional | None | $26.92 | $58.88 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $204.17 | Professional | None | $34.67 | $67.61 | $204.17 |
Molina Setting Professional Modifier None Typical Low $18.20 Median $104.71 Typical High $169.82 | Professional | None | $18.20 | $104.71 | $169.82 |
Pacific Source Setting Facility Modifier None Typical Low $67.61 Median $120.23 Typical High $165.96 | Facility | None | $67.61 | $120.23 | $165.96 |
Premera BCBS Setting Facility Modifier None Typical Low $28.18 Median $39.81 Typical High $112.20 | Facility | None | $28.18 | $39.81 | $112.20 |
Premera BCBS Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $112.20 | Professional | None | $29.51 | $29.51 | $112.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $1,096.48 | Facility | None | $389.05 | $588.84 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $66.07 Typical High $165.96 | Professional | None | $30.20 | $66.07 | $165.96 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $812.83 | Facility | None | $134.90 | $346.74 | $812.83 |
United Setting Professional Modifier None Typical Low $29.51 Median $72.44 Typical High $190.55 | Professional | None | $29.51 | $72.44 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $26.92 Median $39.81 Typical High $120.23 | Professional | None | $26.92 | $39.81 | $120.23 |
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 $13.80 Median $27.54 Typical High $54.95 | Professional | 52 · Reduced service | $13.80 | $27.54 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $10.96 Typical High $21.88 | Professional | 53 · Discontinued | $5.50 | $10.96 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $40.74 Typical High $83.18 | Professional | 54 · Surgery only | $20.89 | $40.74 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $8.13 Typical High $16.60 | Professional | 55 · Aftercare only | $4.17 | $8.13 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $5.50 Typical High $10.96 | Professional | 56 · Pre-op care only | $2.75 | $5.50 | $10.96 |
Where Washington sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 4th of 51
$97.72
WI $123KY $36.31
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.