How much rates vary
Facilitymedian $224 · 10th to 90th $89 to $813Professionalmedian $224 · 10th to 90th $107 to $398
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 $141.25 Median $4,677.35 Typical High $20,892.96 | Facility | None | $141.25 | $4,677.35 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $239.88 | Professional | None | $131.83 | $169.82 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $67.61 Median $562.34 Typical High $1,096.48 | Facility | None | $67.61 | $562.34 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $141.25 Median $269.15 Typical High $1,380.38 | Professional | None | $141.25 | $269.15 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $165.96 Typical High $281.84 | Facility | None | $66.07 | $165.96 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $331.13 | Professional | None | $131.83 | $194.98 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $407.38 | Professional | None | $128.82 | $223.87 | $407.38 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $239.88 Typical High $389.05 | Professional | None | $42.66 | $239.88 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $309.03 Typical High $331.13 | Facility | None | $177.83 | $309.03 | $331.13 |
Premera BCBS Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $218.78 | Facility | None | $66.07 | $112.20 | $218.78 |
Premera BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $229.09 | Professional | None | $144.54 | $144.54 | $229.09 |
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 $141.25 Median $223.87 Typical High $331.13 | Professional | None | $141.25 | $223.87 | $331.13 |
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 $131.83 Median $208.93 Typical High $407.38 | Professional | None | $131.83 | $208.93 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $234.42 | Professional | None | $123.03 | $186.21 | $234.42 |
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 $67.61 Median $75.86 Typical High $112.20 | Professional | 52 · Reduced service | $67.61 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $26.92 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $100.00 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $19.95 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.49 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $107.15 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $93.33 | $107.15 | $154.88 |
Where Washington sits
The same service costs 3.5 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
$224
AK $427KY $123
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.