How much rates vary
Facilitymedian $417 · 10th to 90th $100 to $2,754Professionalmedian $107 · 10th to 90th $89 to $575
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 $100.00 Median $7,943.28 Typical High $27,542.29 | Facility | None | $100.00 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | None | $100.00 | $100.00 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $57.54 Median $1,698.24 Typical High $3,467.37 | Facility | None | $57.54 | $1,698.24 | $3,467.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $107.15 Median $575.44 Typical High $676.08 | Professional | None | $107.15 | $575.44 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $630.96 Typical High $1,047.13 | Facility | None | $66.07 | $630.96 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $194.98 | Professional | None | $75.86 | $89.13 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $436.52 Typical High $851.14 | Professional | None | $123.03 | $436.52 | $851.14 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $50.12 Typical High $72.44 | Professional | None | $7.24 | $50.12 | $72.44 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $158.49 | Facility | None | $109.65 | $144.54 | $158.49 |
Premera BCBS Setting Facility Modifier None Typical Low $40.74 Median $331.13 Typical High $588.84 | Facility | None | $40.74 | $331.13 | $588.84 |
Premera BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $3,467.37 | Facility | None | $1,230.27 | $1,819.70 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $190.55 | Professional | None | $100.00 | $107.15 | $190.55 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $2,884.03 | Facility | None | $134.90 | $346.74 | $2,884.03 |
United Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $245.47 | Professional | None | $91.20 | $107.15 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
5 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 $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 54 · Surgery only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Where Washington sits
The same service costs 5.5 times more in Arkansas 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· 18th of 51
$120
AR $331KY $60.26
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.