How much rates vary
Facilitymedian $1,000 · 10th to 90th $589 to $2,754Professionalmedian $1,318 · 10th to 90th $105 to $2,692
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 $1,698.24 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,698.24 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,698.24 | $1,698.24 | $1,737.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $933.25 Typical High $8,317.64 | Facility | None | $30.20 | $933.25 | $8,317.64 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,862.09 Median $9,332.54 Typical High $10,964.78 | Professional | None | $1,862.09 | $9,332.54 | $10,964.78 |
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 $1,659.59 Median $1,819.70 Typical High $3,801.89 | Professional | None | $1,659.59 | $1,819.70 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $3,630.78 | Professional | None | $1,905.46 | $2,754.23 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $1,148.15 Typical High $2,511.89 | Professional | None | $100.00 | $1,148.15 | $2,511.89 |
Pacific Source Setting Facility Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $2,754.23 | Facility | None | $1,995.26 | $2,570.40 | $2,754.23 |
Premera BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,862.09 | Facility | None | $1,819.70 | $1,819.70 | $1,862.09 |
Premera BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,691.53 | $3,801.89 |
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 $1,737.80 Median $2,344.23 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,344.23 | $4,168.69 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,698.24 | $2,454.71 |
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 $831.76 Median $831.76 Typical High $870.96 | Professional | 52 · Reduced service | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 53 · Discontinued | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,230.27 |
Where Washington sits
The same service costs 9.1 times more in Alabama than in Maryland. 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 $18,845MD $2,076
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.