How much rates vary
Facilitymedian $355 · 10th to 90th $78 to $1,380Professionalmedian $257 · 10th to 90th $63 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 $257.04 Median $4,677.35 Typical High $20,892.96 | Facility | None | $257.04 | $4,677.35 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $275.42 | Professional | None | $141.25 | $177.83 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $77.62 Median $562.34 Typical High $1,096.48 | Facility | None | $77.62 | $562.34 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $1,621.81 | Professional | None | $162.18 | $309.03 | $1,621.81 |
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 $154.88 Median $229.09 Typical High $380.19 | Professional | None | $154.88 | $229.09 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $489.78 | Professional | None | $190.55 | $302.00 | $489.78 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $257.04 Typical High $446.68 | Professional | None | $48.98 | $257.04 | $446.68 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $389.05 | Facility | None | $218.78 | $331.13 | $389.05 |
Premera BCBS Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $257.04 | Facility | None | $56.23 | $75.86 | $257.04 |
Premera BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
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 $162.18 Median $263.03 Typical High $389.05 | Professional | None | $162.18 | $263.03 | $389.05 |
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 $154.88 Median $245.47 Typical High $467.74 | Professional | None | $154.88 | $245.47 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $275.42 | Professional | None | $141.25 | $213.80 | $275.42 |
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 $77.62 Median $89.13 Typical High $128.82 | Professional | 52 · Reduced service | $77.62 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $51.29 | Professional | 53 · Discontinued | $30.90 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $194.98 | Professional | 54 · Surgery only | $117.49 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $38.90 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.78 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.49 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $125.89 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $109.65 | $125.89 | $181.97 |
Where Washington sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$257
AK $490MD $148
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.