How much rates vary
Facilitymedian $1,820 · 10th to 90th $288 to $13,183Professionalmedian $186 · 10th to 90th $40 to $339
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 $190.55 Median $5,128.61 Typical High $20,892.96 | Facility | None | $190.55 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $316.23 | Professional | None | $141.25 | $190.55 | $316.23 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $93.33 Median $1,000.00 Typical High $14,454.40 | Facility | None | $93.33 | $1,000.00 | $14,454.40 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $2,089.30 | Professional | None | $194.98 | $363.08 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $3,981.07 | Facility | None | $630.96 | $2,187.76 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $436.52 | Professional | None | $169.82 | $204.17 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $3,548.13 | Professional | None | $204.17 | $363.08 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $165.96 Typical High $295.12 | Professional | None | $28.18 | $165.96 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $281.84 | Facility | None | $165.96 | $275.42 | $281.84 |
Premera BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,548.82 Typical High $2,818.38 | Facility | None | $794.33 | $1,548.82 | $2,818.38 |
Premera BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,244.36 Median $10,964.78 Typical High $20,892.96 | Facility | None | $7,244.36 | $10,964.78 | $20,892.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $398.11 | Professional | None | $194.98 | $288.40 | $398.11 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $14,454.40 | Facility | None | $1,202.26 | $1,949.84 | $14,454.40 |
United Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $446.68 | Professional | None | $173.78 | $245.47 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $257.04 | Professional | None | $169.82 | $177.83 | $257.04 |
5 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 $95.50 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $20.89 |
Where Washington sits
The same service costs 14.3 times more in Colorado than in Montana. 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
CO $6,102MT $428
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.