How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,047 to $12,882Professionalmedian $537 · 10th to 90th $93 to $1,318
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 $977.24 Median $11,220.18 Typical High $21,877.62 | Facility | None | $977.24 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $12,302.69 | Facility | None | $501.19 | $1,621.81 | $12,302.69 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $977.24 Median $5,754.40 Typical High $6,309.57 | Professional | None | $977.24 | $5,754.40 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,778.28 Typical High $3,162.28 | Professional | None | $812.83 | $1,778.28 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $478.63 Typical High $1,230.27 | Professional | None | $85.11 | $478.63 | $1,230.27 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,445.44 | Facility | None | $1,000.00 | $1,348.96 | $1,445.44 |
Premera BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $3,162.28 | Facility | None | $1,288.25 | $1,819.70 | $3,162.28 |
Premera BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,244.36 Median $9,772.37 Typical High $17,782.79 | Facility | None | $7,244.36 | $9,772.37 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,621.81 | Professional | None | $977.24 | $977.24 | $1,621.81 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $3,548.13 Typical High $12,882.50 | Facility | None | $2,089.30 | $3,548.13 | $12,882.50 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,995.26 | Professional | None | $851.14 | $1,023.29 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,380.38 | Professional | None | $660.69 | $912.01 | $1,380.38 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
Where Washington sits
The same service costs 4.4 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $9,724MT $2,195
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.