How much rates vary
Facilitymedian $155 · 10th to 90th $4 to $2,754Professionalmedian $6 · 10th to 90th $3 to $17
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 $2.63 Median $3,548.13 Typical High $20,417.38 | Facility | None | $2.63 | $3,548.13 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $6.31 Typical High $10.23 | Professional | None | $2.63 | $6.31 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $2.75 Median $7.94 Typical High $11.22 | Professional | None | $2.75 | $7.94 | $11.22 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.26 Median $1.51 Typical High $89.13 | Facility | None | $1.26 | $1.51 | $89.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2.75 Median $9.33 Typical High $186.21 | Professional | None | $2.75 | $9.33 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $2,691.53 | Facility | None | $50.12 | $75.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $5.50 Typical High $12.88 | Professional | None | $2.88 | $5.50 | $12.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.72 Median $8.71 Typical High $16.98 | Professional | None | $3.72 | $8.71 | $16.98 |
Molina Setting Professional Modifier None Typical Low $0.85 Median $4.37 Typical High $4.57 | Professional | None | $0.85 | $4.37 | $4.57 |
Pacific Source Setting Facility Modifier None Typical Low $9.12 Median $11.48 Typical High $13.49 | Facility | None | $9.12 | $11.48 | $13.49 |
Premera BCBS Setting Facility Modifier None Typical Low $3.63 Median $4.47 Typical High $9.12 | Facility | None | $3.63 | $4.47 | $9.12 |
Premera BCBS Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $9.12 | Professional | None | $2.75 | $2.75 | $9.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $83.18 | Facility | None | $66.07 | $66.07 | $83.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.75 Median $6.17 Typical High $13.49 | Professional | None | $2.75 | $6.17 | $13.49 |
United Setting Facility Modifier None Typical Low $125.89 Median $295.12 Typical High $602.56 | Facility | None | $125.89 | $295.12 | $602.56 |
United Setting Professional Modifier None Typical Low $2.69 Median $6.92 Typical High $16.22 | Professional | None | $2.69 | $6.92 | $16.22 |
Wellpoint Setting Professional Modifier None Typical Low $2.29 Median $4.47 Typical High $9.33 | Professional | None | $2.29 | $4.47 | $9.33 |
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 $1.32 Median $2.88 Typical High $4.47 | Professional | 52 · Reduced service | $1.32 | $2.88 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $1.15 Typical High $1.78 | Professional | 53 · Discontinued | $0.52 | $1.15 | $1.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.00 Median $4.37 Typical High $6.76 | Professional | 54 · Surgery only | $2.00 | $4.37 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.87 Typical High $1.35 | Professional | 55 · Aftercare only | $0.40 | $0.87 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.58 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.26 | $0.58 | $0.89 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $5.13 Median $7.08 Typical High $9.33 | Professional | 59 · Distinct service | $5.13 | $7.08 | $9.33 |
Where Washington sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 18th of 51
$7.24
AK $12.88NE $4.37
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.