How much rates vary
Facilitymedian $871 · 10th to 90th $60 to $3,981Professionalmedian $302 · 10th to 90th $69 to $550
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 $162.18 Median $6,165.95 Typical High $27,542.29 | Facility | None | $162.18 | $6,165.95 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $288.40 | Professional | None | $162.18 | $213.80 | $288.40 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $87.10 Median $2,454.71 Typical High $5,011.87 | Facility | None | $87.10 | $2,454.71 | $5,011.87 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $194.98 Median $407.38 Typical High $1,819.70 | Professional | None | $194.98 | $407.38 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $75.86 | Facility | None | $50.12 | $52.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $512.86 | Professional | None | $138.04 | $218.78 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $489.78 | Professional | None | $181.97 | $288.40 | $489.78 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $309.03 Typical High $549.54 | Professional | None | $57.54 | $309.03 | $549.54 |
Pacific Source Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $380.19 | Facility | None | $213.80 | $346.74 | $380.19 |
Premera BCBS Setting Facility Modifier None Typical Low $23.99 Median $30.20 Typical High $257.04 | Facility | None | $23.99 | $30.20 | $257.04 |
Premera BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $263.03 | Professional | None | $158.49 | $158.49 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,737.80 | $2,630.27 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $467.74 | Professional | None | $177.83 | $302.00 | $467.74 |
United Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $3,715.35 | Facility | None | $588.84 | $977.24 | $3,715.35 |
United Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $524.81 | Professional | None | $154.88 | $269.15 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $302.00 | Professional | None | $158.49 | $251.19 | $302.00 |
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 $81.28 Median $104.71 Typical High $144.54 | Professional | 52 · Reduced service | $81.28 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $41.69 Typical High $57.54 | Professional | 53 · Discontinued | $32.36 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $158.49 Typical High $218.78 | Professional | 54 · Surgery only | $123.03 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $43.65 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.89 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $147.91 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $114.82 | $147.91 | $204.17 |
Where Washington sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 7th of 51
$302
WI $589HI $155
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.