How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,000 to $13,183Professionalmedian $646 · 10th to 90th $95 to $1,259
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 $831.76 Median $12,302.69 Typical High $25,118.86 | Facility | None | $831.76 | $12,302.69 | $25,118.86 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $891.25 | Professional | None | $645.65 | $831.76 | $891.25 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $13,489.63 | Facility | None | $436.52 | $1,659.59 | $13,489.63 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $977.24 Median $4,265.80 Typical High $5,128.61 | Professional | None | $977.24 | $4,265.80 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $4,265.80 | Facility | None | $1,000.00 | $2,344.23 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,479.11 | Professional | None | $645.65 | $707.95 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $1,288.25 Typical High $3,311.31 | Professional | None | $575.44 | $1,288.25 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $588.84 Typical High $1,202.26 | Professional | None | $91.20 | $588.84 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,202.26 | Facility | None | $851.14 | $1,148.15 | $1,202.26 |
Premera BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $2,884.03 | Facility | None | $1,174.90 | $1,778.28 | $2,884.03 |
Premera BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,244.36 Median $10,000.00 Typical High $19,054.61 | Facility | None | $7,244.36 | $10,000.00 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,412.54 | Professional | None | $977.24 | $977.24 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $14,125.38 | Facility | None | $1,513.56 | $2,570.40 | $14,125.38 |
United Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Professional | None | $691.83 | $851.14 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,202.26 | Professional | None | $575.44 | $776.25 | $1,202.26 |
7 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 $323.59 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $323.59 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $575.44 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $10,964.78 Median $15,135.61 Typical High $28,840.32 | Facility | 50 · Both sides | $10,964.78 | $15,135.61 | $28,840.32 |
Where Washington sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,787MT $1,955
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.