How much rates vary
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 $933.25 Median $11,220.18 Typical High $21,877.62 | Facility | None | $933.25 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,023.29 | Professional | None | $794.33 | $933.25 | $1,023.29 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $489.78 Median $9,332.54 Typical High $19,054.61 | Facility | None | $489.78 | $9,332.54 | $19,054.61 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $954.99 Median $5,370.32 Typical High $5,495.41 | Professional | None | $954.99 | $5,370.32 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,344.23 Typical High $4,265.80 | Facility | None | $707.95 | $2,344.23 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $2,041.74 | Professional | None | $851.14 | $933.25 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $3,630.78 | Professional | None | $1,096.48 | $1,778.28 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $776.25 Typical High $1,584.89 | Professional | None | $102.33 | $776.25 | $1,584.89 |
Pacific Source Setting Facility Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,445.44 | Facility | None | $1,023.29 | $1,380.38 | $1,445.44 |
Premera BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $3,388.44 | Facility | None | $1,412.54 | $1,995.26 | $3,388.44 |
Premera BCBS Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,244.36 Median $10,000.00 Typical High $19,054.61 | Facility | None | $7,244.36 | $10,000.00 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,905.46 | Professional | None | $954.99 | $1,412.54 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $14,125.38 | Facility | None | $1,513.56 | $2,570.40 | $14,125.38 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,238.72 | Professional | None | $870.96 | $1,202.26 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,348.96 | Professional | None | $870.96 | $912.01 | $1,348.96 |
7 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 $467.74 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $186.21 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $707.95 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $10,964.78 Median $15,135.61 Typical High $28,840.32 | Facility | 50 · Both sides | $10,964.78 | $15,135.61 | $28,840.32 |
Where Washington sits
The same service costs 6.3 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· 41st of 51
$851
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.