How much rates vary
Facilitymedian $631 · 10th to 90th $178 to $11,749Professionalmedian $302 · 10th to 90th $72 to $562
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 $288.40 Median $4,677.35 Typical High $20,892.96 | Facility | None | $288.40 | $4,677.35 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $354.81 | Professional | None | $138.04 | $204.17 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $87.10 Median $8,709.64 Typical High $17,782.79 | Facility | None | $87.10 | $8,709.64 | $17,782.79 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $1,862.09 | Professional | None | $199.53 | $457.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $436.52 Typical High $1,000.00 | Facility | None | $223.87 | $436.52 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $562.34 | Professional | None | $151.36 | $245.47 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $537.03 | Professional | None | $186.21 | $309.03 | $537.03 |
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 $239.88 Median $389.05 Typical High $436.52 | Facility | None | $239.88 | $389.05 | $436.52 |
Premera BCBS Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $316.23 | Facility | None | $144.54 | $194.98 | $316.23 |
Premera BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $295.12 | Professional | None | $169.82 | $169.82 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,309.57 Median $9,332.54 Typical High $17,782.79 | Facility | None | $6,309.57 | $9,332.54 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $524.81 | Professional | None | $194.98 | $346.74 | $524.81 |
United Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $12,882.50 | Facility | None | $588.84 | $977.24 | $12,882.50 |
United Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $575.44 | Professional | None | $158.49 | $281.84 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $316.23 | Professional | None | $158.49 | $245.47 | $316.23 |
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 $87.10 Median $102.33 Typical High $162.18 | Professional | 52 · Reduced service | $87.10 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $64.57 | Professional | 53 · Discontinued | $34.67 | $41.69 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $245.47 | Professional | 54 · Surgery only | $131.83 | $154.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $48.98 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.38 | $20.42 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $123.03 | $144.54 | $229.09 |
Where Washington sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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· 11th of 51
$302
WI $631KY $166
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.