How much rates vary
Facilitymedian $1,862 · 10th to 90th $427 to $12,303Professionalmedian $288 · 10th to 90th $54 to $537
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 $275.42 Median $6,025.60 Typical High $20,892.96 | Facility | None | $275.42 | $6,025.60 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $398.11 | Professional | None | $239.88 | $275.42 | $398.11 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $125.89 Median $1,148.15 Typical High $13,489.63 | Facility | None | $125.89 | $1,148.15 | $13,489.63 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $2,344.23 | Professional | None | $275.42 | $512.86 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $4,073.80 | Facility | None | $630.96 | $2,187.76 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $575.44 | Professional | None | $218.78 | $275.42 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $3,311.31 | Professional | None | $263.03 | $457.09 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $269.15 Typical High $501.19 | Professional | None | $51.29 | $269.15 | $501.19 |
Pacific Source Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $416.87 | Facility | None | $288.40 | $398.11 | $416.87 |
Premera BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $2,884.03 | Facility | None | $776.25 | $1,621.81 | $2,884.03 |
Premera BCBS Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | None | $251.19 | $251.19 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,760.83 Median $10,000.00 Typical High $19,498.45 | Facility | None | $6,760.83 | $10,000.00 | $19,498.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $537.03 | Professional | None | $251.19 | $380.19 | $537.03 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $13,803.84 | Facility | None | $1,202.26 | $1,949.84 | $13,803.84 |
United Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $602.56 | Professional | None | $234.42 | $331.13 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $346.74 | Professional | None | $229.09 | $302.00 | $346.74 |
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 $117.49 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $117.49 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $47.86 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $177.83 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $194.98 |
Where Washington sits
The same service costs 5.9 times more in Oklahoma than in Utah. 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· 25th of 51
$295
OK $1,175UT $200
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.