How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,047 to $12,589Professionalmedian $661 · 10th to 90th $132 to $1,660
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 $1,174.90 Median $11,220.18 Typical High $21,877.62 | Facility | None | $1,174.90 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,258.93 | Professional | None | $891.25 | $1,174.90 | $1,258.93 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $12,302.69 | Facility | None | $630.96 | $1,513.56 | $12,302.69 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,230.27 Median $6,606.93 Typical High $7,244.36 | Professional | None | $1,230.27 | $6,606.93 | $7,244.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,949.84 Typical High $3,162.28 | Professional | None | $954.99 | $1,949.84 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $575.44 Typical High $1,548.82 | Professional | None | $128.82 | $575.44 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,778.28 | Facility | None | $1,348.96 | $1,621.81 | $1,778.28 |
Premera BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,691.53 | Facility | None | $1,096.48 | $1,621.81 | $2,691.53 |
Premera BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,309.57 Median $9,549.93 Typical High $17,782.79 | Facility | None | $6,309.57 | $9,549.93 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,230.27 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $12,882.50 | Facility | None | $1,513.56 | $2,570.40 | $12,882.50 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,344.23 | Professional | None | $977.24 | $1,202.26 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,819.70 | Professional | None | $851.14 | $1,148.15 | $1,819.70 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Washington sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.