How much rates vary
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 $851.14 Median $11,220.18 Typical High $21,877.62 | Facility | None | $851.14 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | None | $851.14 | $851.14 | $933.25 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $467.74 Median $19,054.61 Typical High $39,810.72 | Facility | None | $467.74 | $19,054.61 | $39,810.72 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $5,888.44 | Professional | None | $912.01 | $1,380.38 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,677.35 Typical High $8,709.64 | Facility | None | $707.95 | $4,677.35 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,479.11 | Professional | None | $660.69 | $794.33 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,862.09 Typical High $7,079.46 | Professional | None | $741.31 | $1,862.09 | $7,079.46 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $436.52 Typical High $1,122.02 | Professional | None | $85.11 | $436.52 | $1,122.02 |
Pacific Source Setting Facility Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,348.96 | Facility | None | $870.96 | $1,258.93 | $1,348.96 |
Premera BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $6,025.60 | Facility | None | $1,288.25 | $3,467.37 | $6,025.60 |
Premera BCBS Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,803.84 Median $20,892.96 Typical High $39,810.72 | Facility | None | $13,803.84 | $20,892.96 | $39,810.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,513.56 | Professional | None | $912.01 | $912.01 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $28,183.83 | Facility | None | $1,513.56 | $2,570.40 | $28,183.83 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,862.09 | Professional | None | $758.58 | $933.25 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,318.26 | Professional | None | $630.96 | $851.14 | $1,318.26 |
7 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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $20,892.96 Median $31,622.78 Typical High $58,884.37 | Facility | 50 · Both sides | $20,892.96 | $31,622.78 | $58,884.37 |
Where Washington sits
The same service costs 8.1 times more in Alaska than in Texas. 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· 49th of 51
$525
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.