How much rates vary
Facilitymedian $708 · 10th to 90th $302 to $2,188Professionalmedian $302 · 10th to 90th $69 to $479
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 $229.09 Median $7,943.28 Typical High $27,542.29 | Facility | None | $229.09 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $346.74 | Professional | None | $169.82 | $229.09 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $128.82 Typical High $1,122.02 | Facility | None | $30.20 | $128.82 | $1,122.02 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $3,311.31 | Professional | None | $257.04 | $467.74 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $2,691.53 | Facility | None | $707.95 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $512.86 | Professional | None | $223.87 | $245.47 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $501.19 | Professional | None | $251.19 | $371.54 | $501.19 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $309.03 Typical High $467.74 | Professional | None | $51.29 | $309.03 | $467.74 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $363.08 | Facility | None | $269.15 | $346.74 | $363.08 |
Premera BCBS Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Premera BCBS Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $512.86 | Professional | None | $257.04 | $363.08 | $512.86 |
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 $229.09 Median $309.03 Typical High $562.34 | Professional | None | $229.09 | $309.03 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $331.13 | Professional | None | $223.87 | $234.42 | $331.13 |
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 $114.82 Median $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.99 |
Where Washington sits
The same service costs 56.5 times more in Alabama 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
AL $31,874MT $564
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.