How much rates vary
Facilitymedian $631 · 10th to 90th $339 to $3,548Professionalmedian $295 · 10th to 90th $148 to $537
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 $295.12 Median $6,165.95 Typical High $20,892.96 | Facility | None | $295.12 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $316.23 | Professional | None | $229.09 | $295.12 | $316.23 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $158.49 Median $870.96 Typical High $3,467.37 | Facility | None | $158.49 | $870.96 | $3,467.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $338.84 Median $1,513.56 Typical High $1,862.09 | Professional | None | $338.84 | $1,513.56 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $707.95 Typical High $1,318.26 | Facility | None | $467.74 | $707.95 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $524.81 | Professional | None | $251.19 | $251.19 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $457.09 Typical High $977.24 | Professional | None | $204.17 | $457.09 | $977.24 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $512.86 | Professional | None | $138.04 | $281.84 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $281.84 Median $380.19 Typical High $426.58 | Facility | None | $281.84 | $380.19 | $426.58 |
Premera BCBS Setting Facility Modifier None Typical Low $245.47 Median $478.63 Typical High $851.14 | Facility | None | $245.47 | $478.63 | $851.14 |
Premera BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $5,011.87 | Facility | None | $1,778.28 | $2,691.53 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $489.78 | Professional | None | $338.84 | $338.84 | $489.78 |
United Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $3,630.78 | Facility | None | $371.54 | $691.83 | $3,630.78 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $549.54 | Professional | None | $234.42 | $302.00 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $436.52 | Professional | None | $208.93 | $281.84 | $436.52 |
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 $114.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $169.82 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $158.49 | $204.17 | $204.17 |
Where Washington sits
The same service costs 5.5 times more in Oklahoma than in West Virginia. 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
OK $3,794WV $692
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.