How much rates vary
Facilitymedian $617 · 10th to 90th $355 to $3,631Professionalmedian $275 · 10th to 90th $50 to $589
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 $141.25 Median $2,137.96 Typical High $9,549.93 | Facility | None | $141.25 | $2,137.96 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $354.81 | Professional | None | $114.82 | $181.97 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $295.12 Typical High $295.12 | Professional | None | $114.82 | $295.12 | $295.12 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $93.33 Median $724.44 Typical High $3,467.37 | Facility | None | $93.33 | $724.44 | $3,467.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $158.49 Median $478.63 Typical High $2,344.23 | Professional | None | $158.49 | $478.63 | $2,344.23 |
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 $117.49 Median $245.47 Typical High $398.11 | Professional | None | $117.49 | $245.47 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $269.15 Typical High $812.83 | Professional | None | $114.82 | $269.15 | $812.83 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $281.84 Typical High $575.44 | Professional | None | $46.77 | $281.84 | $575.44 |
Pacific Source Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $478.63 | Facility | None | $239.88 | $416.87 | $478.63 |
Premera BCBS Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $891.25 | Facility | None | $323.59 | $524.81 | $891.25 |
Premera BCBS Setting Professional Modifier None Typical Low $141.25 Median $323.59 Typical High $323.59 | Professional | None | $141.25 | $323.59 | $323.59 |
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 $158.49 Median $316.23 Typical High $478.63 | Professional | None | $158.49 | $316.23 | $478.63 |
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 $120.23 Median $239.88 Typical High $416.87 | Professional | None | $120.23 | $239.88 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $602.56 | Professional | None | $104.71 | $257.04 | $602.56 |
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 $70.79 Median $91.20 Typical High $177.83 | Professional | 52 · Reduced service | $70.79 | $91.20 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $70.79 | Professional | 53 · Discontinued | $28.18 | $36.31 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $138.04 Typical High $263.03 | Professional | 54 · Surgery only | $104.71 | $138.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $52.48 | Professional | 55 · Aftercare only | $20.89 | $27.54 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $128.82 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $97.72 | $128.82 | $245.47 |
Where Washington sits
The same service costs 13.1 times more in Vermont 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
VT $5,338WV $408
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.