How much rates vary
Facilitymedian $1,096 · 10th to 90th $562 to $9,550Professionalmedian $3,548 · 10th to 90th $537 to $10,233
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 $4,677.35 Median $7,943.28 Typical High $27,542.29 | Facility | None | $4,677.35 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,918.31 | Professional | None | $6,309.57 | $6,309.57 | $6,918.31 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $3,388.44 Typical High $29,512.09 | Facility | None | $30.20 | $3,388.44 | $29,512.09 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $6,606.93 Median $38,904.51 Typical High $162,181.01 | Professional | None | $6,606.93 | $38,904.51 | $162,181.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,888.44 Median $9,772.37 Typical High $12,302.69 | Professional | None | $5,888.44 | $9,772.37 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $3,019.95 Typical High $9,772.37 | Professional | None | $537.03 | $3,019.95 | $9,772.37 |
Pacific Source Setting Facility Modifier None Typical Low $5,623.41 Median $8,511.38 Typical High $9,549.93 | Facility | None | $5,623.41 | $8,511.38 | $9,549.93 |
Premera BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
Premera BCBS Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,606.93 Median $9,549.93 Typical High $12,882.50 | Professional | None | $6,606.93 | $9,549.93 | $12,882.50 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $5,128.61 Median $8,128.31 Typical High $14,791.08 | Professional | None | $5,128.61 | $8,128.31 | $14,791.08 |
Wellpoint Setting Professional Modifier None Typical Low $5,888.44 Median $6,165.95 Typical High $8,912.51 | Professional | None | $5,888.44 | $6,165.95 | $8,912.51 |
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 $3,162.28 Median $3,162.28 Typical High $3,467.37 | Professional | 52 · Reduced service | $3,162.28 | $3,162.28 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | 53 · Discontinued | $1,258.93 | $1,258.93 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,786.30 Median $4,786.30 Typical High $5,248.07 | Professional | 54 · Surgery only | $4,786.30 | $4,786.30 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | 55 · Aftercare only | $954.99 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 56 · Pre-op care only | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,466.84 Median $4,466.84 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $4,466.84 | $4,466.84 | $4,897.79 |
Where Washington sits
The same service costs 8.4 times more in Wisconsin 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.
Physician feeFacility fee
WI $28,671TX $3,407
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.