How much rates vary
Facilitymedian $240 · 10th to 90th $110 to $1,380Professionalmedian $240 · 10th to 90th $110 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 $239.88 Median $5,128.61 Typical High $20,892.96 | Facility | None | $239.88 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | None | $151.36 | $181.97 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $478.63 | Professional | None | $204.17 | $204.17 | $478.63 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $74.13 Median $1,071.52 Typical High $2,187.76 | Facility | None | $74.13 | $1,071.52 | $2,187.76 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $1,513.56 | Professional | None | $158.49 | $302.00 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $169.82 Typical High $288.40 | Facility | None | $66.07 | $169.82 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $371.54 | Professional | None | $147.91 | $213.80 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $436.52 | Professional | None | $134.90 | $245.47 | $436.52 |
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 $194.98 Median $338.84 Typical High $354.81 | Facility | None | $194.98 | $338.84 | $354.81 |
Premera BCBS Setting Facility Modifier None Typical Low $97.72 Median $131.83 Typical High $239.88 | Facility | None | $97.72 | $131.83 | $239.88 |
Premera BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | None | $162.18 | $162.18 | $245.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $2,187.76 | Facility | None | $776.25 | $1,174.90 | $2,187.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $363.08 | Professional | None | $158.49 | $245.47 | $363.08 |
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 $151.36 Median $229.09 Typical High $446.68 | Professional | None | $151.36 | $229.09 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $257.04 | Professional | None | $100.00 | $181.97 | $257.04 |
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 $75.86 Median $83.18 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $123.03 Typical High $181.97 | Professional | 54 · Surgery only | $112.20 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $36.31 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $114.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $104.71 | $114.82 | $169.82 |
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
$240
AK $479KY $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.