How much rates vary
Facilitymedian $1,479 · 10th to 90th $676 to $7,943Professionalmedian $417 · 10th to 90th $83 to $759
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 $380.19 Median $11,220.18 Typical High $21,877.62 | Facility | None | $380.19 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $630.96 | Professional | None | $302.00 | $380.19 | $630.96 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $204.17 Median $1,621.81 Typical High $7,943.28 | Facility | None | $204.17 | $1,621.81 | $7,943.28 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $6,918.31 | Professional | None | $398.11 | $741.31 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,570.40 | Facility | None | $891.25 | $1,380.38 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $851.14 | Professional | None | $346.74 | $398.11 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $2,089.30 | Professional | None | $436.52 | $741.31 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $416.87 Typical High $724.44 | Professional | None | $70.79 | $416.87 | $724.44 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $575.44 | Facility | None | $436.52 | $549.54 | $575.44 |
Premera BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,862.09 | Facility | None | $794.33 | $1,096.48 | $1,862.09 |
Premera BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $5,888.44 Typical High $11,220.18 | Facility | None | $4,570.88 | $5,888.44 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $812.83 | Professional | None | $398.11 | $575.44 | $812.83 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $8,128.31 | Facility | None | $1,202.26 | $1,949.84 | $8,128.31 |
United Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $912.01 | Professional | None | $354.81 | $489.78 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $575.44 | Professional | None | $371.54 | $389.05 | $575.44 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $269.15 |
Where Washington sits
The same service costs 6.6 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 $6,126MT $925
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.