How much rates vary
Facilitymedian $302 · 10th to 90th $52 to $912Professionalmedian $186 · 10th to 90th $74 to $347
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 $75.86 Median $6,165.95 Typical High $27,542.29 | Facility | None | $75.86 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $204.17 | Professional | None | $67.61 | $104.71 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $295.12 | Professional | None | $141.25 | $275.42 | $295.12 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $36.31 Median $537.03 Typical High $1,096.48 | Facility | None | $36.31 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $81.28 Median $199.53 Typical High $1,122.02 | Professional | None | $81.28 | $199.53 | $1,122.02 |
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 $75.86 Median $144.54 Typical High $257.04 | Professional | None | $75.86 | $144.54 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $363.08 | Professional | None | $95.50 | $173.78 | $363.08 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $208.93 Typical High $346.74 | Professional | None | $37.15 | $208.93 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $275.42 | Facility | None | $131.83 | $269.15 | $275.42 |
Premera BCBS Setting Facility Modifier None Typical Low $32.36 Median $42.66 Typical High $186.21 | Facility | None | $32.36 | $42.66 | $186.21 |
Premera BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $186.21 | Professional | None | $81.28 | $81.28 | $186.21 |
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 $81.28 Median $162.18 Typical High $275.42 | Professional | None | $81.28 | $162.18 | $275.42 |
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 $77.62 Median $165.96 Typical High $338.84 | Professional | None | $77.62 | $165.96 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $190.55 | Professional | None | $66.07 | $100.00 | $190.55 |
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 $38.02 Median $52.48 Typical High $97.72 | Professional | 52 · Reduced service | $38.02 | $52.48 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $20.89 Typical High $38.90 | Professional | 53 · Discontinued | $15.14 | $20.89 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $77.62 Typical High $144.54 | Professional | 54 · Surgery only | $57.54 | $77.62 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.49 Typical High $28.84 | Professional | 55 · Aftercare only | $11.48 | $15.49 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.47 Typical High $19.50 | Professional | 56 · Pre-op care only | $7.59 | $10.47 | $19.50 |
Where Washington sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 5th of 51
$186
AK $302NJ $85.11
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.