How much rates vary
Facilitymedian $195 · 10th to 90th $81 to $1,000Professionalmedian $148 · 10th to 90th $34 to $288
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 $158.49 Median $4,677.35 Typical High $20,892.96 | Facility | None | $158.49 | $4,677.35 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $208.93 | Professional | None | $123.03 | $158.49 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $93.33 Median $630.96 Typical High $1,318.26 | Facility | None | $93.33 | $630.96 | $1,318.26 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $1,122.02 | Professional | None | $162.18 | $251.19 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $229.09 | Facility | None | $66.07 | $138.04 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $281.84 | Professional | None | $125.89 | $147.91 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $309.03 | Professional | None | $104.71 | $169.82 | $309.03 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $120.23 Typical High $275.42 | Professional | None | $31.62 | $120.23 | $275.42 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $251.19 | Facility | None | $165.96 | $234.42 | $251.19 |
Premera BCBS Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $162.18 | Facility | None | $66.07 | $93.33 | $162.18 |
Premera BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | None | $169.82 | $169.82 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $1,318.26 | Facility | None | $457.09 | $691.83 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $269.15 | Professional | None | $162.18 | $165.96 | $269.15 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $1,000.00 | Facility | None | $134.90 | $346.74 | $1,000.00 |
United Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $323.59 | Professional | None | $134.90 | $165.96 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $275.42 | Professional | None | $128.82 | $173.78 | $275.42 |
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 $79.43 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $109.65 | $112.20 | $112.20 |
Where Washington sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 30th of 51
$148
AK $501UT $97.72
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.