How much rates vary
Facilitymedian $776 · 10th to 90th $269 to $6,166Professionalmedian $331 · 10th to 90th $50 to $741
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 $524.81 Median $6,165.95 Typical High $20,892.96 | Facility | None | $524.81 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $524.81 | Professional | None | $316.23 | $398.11 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $524.81 | Professional | None | $263.03 | $263.03 | $524.81 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $177.83 Median $4,265.80 Typical High $8,912.51 | Facility | None | $177.83 | $4,265.80 | $8,912.51 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $338.84 Median $676.08 Typical High $3,235.94 | Professional | None | $338.84 | $676.08 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $616.60 Typical High $1,000.00 | Facility | None | $323.59 | $616.60 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $707.95 | Professional | None | $302.00 | $446.68 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $891.25 | Professional | None | $269.15 | $467.74 | $891.25 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $275.42 Typical High $707.95 | Professional | None | $46.77 | $275.42 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $776.25 | Facility | None | $549.54 | $741.31 | $776.25 |
Premera BCBS Setting Facility Modifier None Typical Low $218.78 Median $288.40 Typical High $501.19 | Facility | None | $218.78 | $288.40 | $501.19 |
Premera BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $524.81 | Professional | None | $346.74 | $346.74 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,630.78 Median $4,677.35 Typical High $8,912.51 | Facility | None | $3,630.78 | $4,677.35 | $8,912.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $776.25 | Professional | None | $338.84 | $524.81 | $776.25 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $6,309.57 | Facility | None | $1,202.26 | $1,949.84 | $6,309.57 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $851.14 | Professional | None | $316.23 | $489.78 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $549.54 | Professional | None | $245.47 | $389.05 | $549.54 |
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 $158.49 Median $181.97 Typical High $257.04 | Professional | 52 · Reduced service | $158.49 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $104.71 | Professional | 53 · Discontinued | $64.57 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $275.42 Typical High $389.05 | Professional | 54 · Surgery only | $239.88 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $54.95 Typical High $77.62 | Professional | 55 · Aftercare only | $47.86 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $36.31 Typical High $52.48 | Professional | 56 · Pre-op care only | $31.62 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $257.04 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $223.87 | $257.04 | $363.08 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $5,495.41 Median $7,079.46 Typical High $13,489.63 | Facility | 50 · Both sides | $5,495.41 | $7,079.46 | $13,489.63 |
Where Washington sits
The same service costs 4.3 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· 43rd of 51
$331
AK $1,023TX $240
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.