How much rates vary
Facilitymedian $309 · 10th to 90th $63 to $1,318Professionalmedian $138 · 10th to 90th $81 to $257
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 $131.83 Median $5,128.61 Typical High $20,892.96 | Facility | None | $131.83 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $141.25 | Professional | None | $74.13 | $97.72 | $141.25 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $44.67 Median $537.03 Typical High $1,096.48 | Facility | None | $44.67 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $831.76 | Professional | None | $95.50 | $177.83 | $831.76 |
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 $83.18 Median $112.20 Typical High $218.78 | Professional | None | $83.18 | $112.20 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $251.19 | Professional | None | $107.15 | $173.78 | $251.19 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $158.49 Typical High $257.04 | Professional | None | $27.54 | $158.49 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $173.78 Typical High $194.98 | Facility | None | $131.83 | $173.78 | $194.98 |
Premera BCBS Setting Facility Modifier None Typical Low $47.86 Median $56.23 Typical High $134.90 | Facility | None | $47.86 | $56.23 | $134.90 |
Premera BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $138.04 | Professional | None | $97.72 | $97.72 | $138.04 |
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 $95.50 Median $138.04 Typical High $204.17 | Professional | None | $95.50 | $138.04 | $204.17 |
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 $85.11 Median $123.03 Typical High $245.47 | Professional | None | $85.11 | $123.03 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $141.25 | Professional | None | $81.28 | $114.82 | $141.25 |
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 $45.71 Median $48.98 Typical High $66.07 | Professional | 52 · Reduced service | $45.71 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $18.20 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $74.13 Typical High $100.00 | Professional | 54 · Surgery only | $67.61 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $69.18 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $63.10 | $69.18 | $93.33 |
Where Washington sits
The same service costs 3.8 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· 8th of 51
$138
AK $288KY $75.86
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.