How much rates vary
Facilitymedian $1,122 · 10th to 90th $603 to $7,244Professionalmedian $490 · 10th to 90th $63 to $794
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 $380.19 Median $524.81 Typical High $562.34 | Professional | None | $380.19 | $524.81 | $562.34 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $275.42 Median $1,148.15 Typical High $7,079.46 | Facility | None | $275.42 | $1,148.15 | $7,079.46 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $562.34 Median $2,884.03 Typical High $3,162.28 | Professional | None | $562.34 | $2,884.03 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $2,951.21 | Facility | None | $630.96 | $1,513.56 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,148.15 | Professional | None | $489.78 | $537.03 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $2,398.83 | Professional | None | $707.95 | $1,096.48 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $436.52 Typical High $741.31 | Professional | None | $63.10 | $436.52 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $812.83 | Facility | None | $575.44 | $741.31 | $812.83 |
Premera BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,047.13 Typical High $1,698.24 | Facility | None | $616.60 | $1,047.13 | $1,698.24 |
Premera BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,548.13 Median $5,370.32 Typical High $10,000.00 | Facility | None | $3,548.13 | $5,370.32 | $10,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,148.15 | Professional | None | $562.34 | $794.33 | $1,148.15 |
United Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $8,128.31 | Facility | None | $588.84 | $977.24 | $8,128.31 |
United Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,258.93 | Professional | None | $512.86 | $691.83 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $741.31 | Professional | None | $489.78 | $512.86 | $741.31 |
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 $263.03 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $380.19 |
Where Washington sits
The same service costs 4.1 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 $4,954MT $1,220
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.