How much rates vary
Facilitymedian $2,188 · 10th to 90th $91 to $6,166Professionalmedian $120 · 10th to 90th $58 to $245
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 $54.95 Median $2,137.96 Typical High $20,417.38 | Facility | None | $54.95 | $2,137.96 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $128.82 | Professional | None | $54.95 | $102.33 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $28.84 Median $1,819.70 Typical High $3,981.07 | Facility | None | $28.84 | $1,819.70 | $3,981.07 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $1,778.28 | Professional | None | $58.88 | $120.23 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $165.96 | Professional | None | $63.10 | $100.00 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $194.98 | Professional | None | $61.66 | $107.15 | $194.98 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $144.54 Typical High $251.19 | Professional | None | $61.66 | $144.54 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $199.53 | Facility | None | $147.91 | $173.78 | $199.53 |
Premera BCBS Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Premera BCBS Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $120.23 | Professional | None | $58.88 | $120.23 | $120.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $3,801.89 | Facility | None | $1,288.25 | $1,995.26 | $3,801.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $177.83 | Professional | None | $58.88 | $120.23 | $177.83 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $4,786.30 | Facility | None | $1,862.09 | $2,691.53 | $4,786.30 |
United Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $173.78 | Professional | None | $56.23 | $107.15 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $38.02 Median $91.20 Typical High $199.53 | Professional | None | $38.02 | $91.20 | $199.53 |
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 $27.54 Median $45.71 Typical High $60.26 | Professional | 52 · Reduced service | $27.54 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.20 Typical High $23.99 | Professional | 53 · Discontinued | $10.96 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $69.18 Typical High $91.20 | Professional | 54 · Surgery only | $41.69 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.80 Typical High $18.20 | Professional | 55 · Aftercare only | $8.32 | $13.80 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.50 | $9.12 | $12.02 |
Where Washington sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 10th of 51
$120
NC $174FL $70.79
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.