How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $4,571Professionalmedian $219 · 10th to 90th $112 to $372
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 $524.81 Median $6,309.57 Typical High $20,892.96 | Facility | None | $524.81 | $6,309.57 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $257.04 | Professional | None | $223.87 | $229.09 | $257.04 |
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 $114.82 Median $870.96 Typical High $4,570.88 | Facility | None | $114.82 | $870.96 | $4,570.88 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $1,995.26 | Professional | None | $263.03 | $426.58 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $912.01 Typical High $1,659.59 | Facility | None | $467.74 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $436.52 | Professional | None | $204.17 | $204.17 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $380.19 Typical High $1,258.93 | Professional | None | $173.78 | $380.19 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $338.84 | Professional | None | $109.65 | $199.53 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $194.98 Median $331.13 Typical High $446.68 | Facility | None | $194.98 | $331.13 | $446.68 |
Premera BCBS Setting Facility Modifier None Typical Low $380.19 Median $645.65 Typical High $1,174.90 | Facility | None | $380.19 | $645.65 | $1,174.90 |
Premera BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,290.87 Median $3,467.37 Typical High $6,456.54 | Facility | None | $2,290.87 | $3,467.37 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $389.05 | Professional | None | $263.03 | $263.03 | $389.05 |
United Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $4,677.35 | Facility | None | $588.84 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $446.68 | Professional | None | $199.53 | $239.88 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $309.03 | Professional | None | $151.36 | $204.17 | $309.03 |
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 $107.15 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $107.15 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $32.36 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $22.91 |
Where Washington sits
The same service costs 7.7 times more in Colorado 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
CO $4,047MT $526
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.