How much rates vary
Facilitymedian $282 · 10th to 90th $112 to $955Professionalmedian $269 · 10th to 90th $50 to $603
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 $398.11 Median $5,128.61 Typical High $20,892.96 | Facility | None | $398.11 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $398.11 | Professional | None | $165.96 | $263.03 | $398.11 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $83.18 Median $691.83 Typical High $1,348.96 | Facility | None | $83.18 | $691.83 | $1,348.96 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $181.97 Median $562.34 Typical High $2,290.87 | Professional | None | $181.97 | $562.34 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $199.53 Typical High $338.84 | Facility | None | $66.07 | $199.53 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $676.08 | Professional | None | $138.04 | $269.15 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $645.65 | Professional | None | $158.49 | $275.42 | $645.65 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $251.19 Typical High $588.84 | Professional | None | $48.98 | $251.19 | $588.84 |
Pacific Source Setting Facility Modifier None Typical Low $234.42 Median $436.52 Typical High $524.81 | Facility | None | $234.42 | $436.52 | $524.81 |
Premera BCBS Setting Facility Modifier None Typical Low $93.33 Median $144.54 Typical High $269.15 | Facility | None | $93.33 | $144.54 | $269.15 |
Premera BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $363.08 | Professional | None | $165.96 | $165.96 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $1,348.96 | Facility | None | $537.03 | $707.95 | $1,348.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $645.65 | Professional | None | $165.96 | $354.81 | $645.65 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $954.99 | Facility | None | $134.90 | $346.74 | $954.99 |
United Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $691.83 | Professional | None | $151.36 | $316.23 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $380.19 | Professional | None | $151.36 | $234.42 | $380.19 |
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 $83.18 Median $109.65 Typical High $194.98 | Professional | 52 · Reduced service | $83.18 | $109.65 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $44.67 Typical High $79.43 | Professional | 53 · Discontinued | $33.11 | $44.67 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $165.96 Typical High $295.12 | Professional | 54 · Surgery only | $123.03 | $165.96 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.11 Typical High $58.88 | Professional | 55 · Aftercare only | $25.12 | $33.11 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $16.60 | $21.88 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $154.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $114.82 | $154.88 | $275.42 |
Where Washington sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 16th of 51
$269
WI $490KY $135
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.