How much rates vary
Facilitymedian $417 · 10th to 90th $151 to $6,166Professionalmedian $257 · 10th to 90th $69 to $457
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 $275.42 Median $5,128.61 Typical High $20,892.96 | Facility | None | $275.42 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $288.40 | Professional | None | $158.49 | $213.80 | $288.40 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $81.28 Median $1,698.24 Typical High $6,309.57 | Facility | None | $81.28 | $1,698.24 | $6,309.57 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $1,698.24 | Professional | None | $165.96 | $316.23 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $630.96 | Facility | None | $186.21 | $363.08 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $389.05 | Professional | None | $144.54 | $234.42 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $478.63 | Professional | None | $165.96 | $269.15 | $478.63 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $257.04 Typical High $457.09 | Professional | None | $50.12 | $257.04 | $457.09 |
Pacific Source Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $398.11 | Facility | None | $208.93 | $371.54 | $398.11 |
Premera BCBS Setting Facility Modifier None Typical Low $117.49 Median $162.18 Typical High $269.15 | Facility | None | $117.49 | $162.18 | $269.15 |
Premera BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $275.42 | Professional | None | $169.82 | $169.82 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $4,786.30 Typical High $8,912.51 | Facility | None | $3,162.28 | $4,786.30 | $8,912.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $398.11 | Professional | None | $165.96 | $269.15 | $398.11 |
United Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $6,456.54 | Facility | None | $371.54 | $691.83 | $6,456.54 |
United Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $489.78 | Professional | None | $151.36 | $251.19 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $288.40 | Professional | None | $147.91 | $229.09 | $288.40 |
6 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 $79.43 Median $87.10 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $35.48 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $35.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $40.74 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $123.03 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $112.20 | $123.03 | $190.55 |
Where Washington sits
The same service costs 3.6 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· 9th of 51
$263
AK $501KY $138
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.