How much rates vary
Facilitymedian $191 · 10th to 90th $72 to $776Professionalmedian $186 · 10th to 90th $78 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 $79.43 Median $6,165.95 Typical High $27,542.29 | Facility | None | $79.43 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $194.98 | Professional | None | $67.61 | $100.00 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $251.19 | Professional | None | $104.71 | $125.89 | $251.19 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $38.02 Median $537.03 Typical High $1,096.48 | Facility | None | $38.02 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $1,148.15 | Professional | None | $83.18 | $190.55 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $239.88 | Facility | None | $66.07 | $144.54 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $251.19 | Professional | None | $77.62 | $131.83 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $302.00 | Professional | None | $100.00 | $151.36 | $302.00 |
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 $223.87 Typical High $269.15 | Facility | None | $131.83 | $223.87 | $269.15 |
Premera BCBS Setting Facility Modifier None Typical Low $39.81 Median $102.33 Typical High $186.21 | Facility | None | $39.81 | $102.33 | $186.21 |
Premera BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $186.21 | Professional | None | $85.11 | $85.11 | $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 $83.18 Median $162.18 Typical High $275.42 | Professional | None | $83.18 | $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 $81.28 Median $162.18 Typical High $338.84 | Professional | None | $81.28 | $162.18 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $51.29 Median $102.33 Typical High $194.98 | Professional | None | $51.29 | $102.33 | $194.98 |
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 $39.81 Median $50.12 Typical High $95.50 | Professional | 52 · Reduced service | $39.81 | $50.12 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.95 Typical High $38.02 | Professional | 53 · Discontinued | $15.85 | $19.95 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $74.13 Typical High $141.25 | Professional | 54 · Surgery only | $60.26 | $74.13 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $28.18 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $19.05 |
Where Washington sits
The same service costs 3.2 times more in Alaska 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
$186
AK $275KY $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.