How much rates vary
Facilitymedian $186 · 10th to 90th $71 to $1,096Professionalmedian $148 · 10th to 90th $49 to $288
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 $66.07 Median $3,388.44 Typical High $20,417.38 | Facility | None | $66.07 | $3,388.44 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $177.83 | Professional | None | $66.07 | $112.20 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $194.98 | Professional | None | $107.15 | $194.98 | $194.98 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $35.48 Median $660.69 Typical High $1,380.38 | Facility | None | $35.48 | $660.69 | $1,380.38 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $77.62 Median $204.17 Typical High $870.96 | Professional | None | $77.62 | $204.17 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $177.83 Typical High $630.96 | Facility | None | $93.33 | $177.83 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $245.47 | Professional | None | $63.10 | $109.65 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $234.42 | Professional | None | $81.28 | $123.03 | $234.42 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $169.82 Typical High $288.40 | Professional | None | $29.51 | $169.82 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $147.91 Median $177.83 Typical High $194.98 | Facility | None | $147.91 | $177.83 | $194.98 |
Premera BCBS Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $131.83 | Facility | None | $57.54 | $77.62 | $131.83 |
Premera BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $134.90 | Professional | None | $70.79 | $70.79 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $478.63 Median $724.44 Typical High $1,380.38 | Facility | None | $478.63 | $724.44 | $1,380.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $234.42 | Professional | None | $69.18 | $131.83 | $234.42 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $1,023.29 | Facility | None | $134.90 | $346.74 | $1,023.29 |
United Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $257.04 | Professional | None | $69.18 | $131.83 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $147.91 | Professional | None | $63.10 | $97.72 | $147.91 |
5 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 $33.11 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $33.11 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $13.18 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $81.28 Typical High $100.00 | Professional | 54 · Surgery only | $48.98 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $10.00 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.61 | $10.96 | $13.18 |
Where Washington sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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.
Washington· 6th of 51
$151
WI $257KY $91.20
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.