How much rates vary
Facilitymedian $302 · 10th to 90th $71 to $933Professionalmedian $200 · 10th to 90th $46 to $363
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 $147.91 Median $5,128.61 Typical High $21,877.62 | Facility | None | $147.91 | $5,128.61 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $257.04 | Professional | None | $117.49 | $162.18 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $239.88 | Professional | None | $141.25 | $239.88 | $239.88 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $74.13 Median $537.03 Typical High $1,096.48 | Facility | None | $74.13 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $1,230.27 | Professional | None | $169.82 | $323.59 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $75.86 | Facility | None | $50.12 | $52.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $371.54 | Professional | None | $131.83 | $186.21 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $363.08 | Professional | None | $151.36 | $269.15 | $363.08 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $194.98 Typical High $346.74 | Professional | None | $37.15 | $194.98 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $288.40 | Facility | None | $204.17 | $269.15 | $288.40 |
Premera BCBS Setting Facility Modifier None Typical Low $32.36 Median $40.74 Typical High $190.55 | Facility | None | $32.36 | $40.74 | $190.55 |
Premera BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | None | $154.88 | $154.88 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $1,096.48 | Facility | None | $389.05 | $588.84 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $354.81 | Professional | None | $147.91 | $234.42 | $354.81 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $812.83 | Facility | None | $134.90 | $346.74 | $812.83 |
United Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $398.11 | Professional | None | $138.04 | $213.80 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $213.80 | Professional | None | $138.04 | $199.53 | $213.80 |
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 $74.13 Median $87.10 Typical High $100.00 | Professional | 52 · Reduced service | $74.13 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $30.20 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $131.83 Typical High $151.36 | Professional | 54 · Surgery only | $112.20 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $22.39 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.79 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $123.03 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $104.71 | $123.03 | $141.25 |
Where Washington sits
The same service costs 4.1 times more in Alaska 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· 13th of 51
$200
AK $457KY $112
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.