How much rates vary
Facilitymedian $2,138 · 10th to 90th $447 to $11,482Professionalmedian $158 · 10th to 90th $30 to $263
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 $151.36 Median $6,165.95 Typical High $20,892.96 | Facility | None | $151.36 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $75.86 Median $794.33 Typical High $12,302.69 | Facility | None | $75.86 | $794.33 | $12,302.69 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $977.24 | Professional | None | $154.88 | $295.12 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $2,570.40 Typical High $4,897.79 | Facility | None | $467.74 | $2,570.40 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $354.81 | Professional | None | $138.04 | $151.36 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $4,365.16 | Professional | None | $213.80 | $323.59 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $158.49 Typical High $245.47 | Professional | None | $26.30 | $158.49 | $245.47 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $223.87 Typical High $229.09 | Facility | None | $131.83 | $223.87 | $229.09 |
Premera BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,754.23 | Facility | None | $1,047.13 | $1,659.59 | $2,754.23 |
Premera BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,456.54 Median $9,332.54 Typical High $17,782.79 | Facility | None | $6,456.54 | $9,332.54 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $331.13 | Professional | None | $154.88 | $229.09 | $331.13 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $12,302.69 | Facility | None | $1,513.56 | $2,570.40 | $12,302.69 |
United Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $363.08 | Professional | None | $141.25 | $194.98 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $208.93 | Professional | None | $138.04 | $144.54 | $208.93 |
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 $75.86 Median $75.86 Typical High $79.43 | Professional | 52 · Reduced service | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | 53 · Discontinued | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 54 · Surgery only | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $23.44 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.85 |
Where Washington sits
The same service costs 12.9 times more in Arkansas than in New York. 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.
Washington· 40th of 51
$182
AR $1,585NY $123
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.