How much rates vary
Facilitymedian $1,072 · 10th to 90th $437 to $7,586Professionalmedian $115 · 10th to 90th $26 to $224
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 $102.33 Median $6,165.95 Typical High $20,892.96 | Facility | None | $102.33 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $151.36 | Professional | None | $100.00 | $100.00 | $151.36 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $53.70 Median $794.33 Typical High $7,943.28 | Facility | None | $53.70 | $794.33 | $7,943.28 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $102.33 Median $602.56 Typical High $676.08 | Professional | None | $102.33 | $602.56 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,318.26 Typical High $2,398.83 | Facility | None | $467.74 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $234.42 | Professional | None | $95.50 | $120.23 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $2,089.30 | Professional | None | $120.23 | $199.53 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $112.20 Typical High $194.98 | Professional | None | $19.50 | $112.20 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $89.13 Median $147.91 Typical High $154.88 | Facility | None | $89.13 | $147.91 | $154.88 |
Premera BCBS Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $1,659.59 | Facility | None | $588.84 | $977.24 | $1,659.59 |
Premera BCBS Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $11,220.18 | Facility | None | $3,981.07 | $5,888.44 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $213.80 | Professional | None | $102.33 | $151.36 | $213.80 |
United Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $8,128.31 | Facility | None | $588.84 | $977.24 | $8,128.31 |
United Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $245.47 | Professional | None | $95.50 | $131.83 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $147.91 | Professional | None | $97.72 | $102.33 | $147.91 |
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 $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 53 · Discontinued | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 54 · Surgery only | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $69.18 | $69.18 | $70.79 |
Where Washington sits
The same service costs 18.4 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 $4,483MT $243
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.