How much rates vary
Facilitymedian $1,738 · 10th to 90th $398 to $11,220Professionalmedian $263 · 10th to 90th $51 to $490
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 $239.88 Median $4,570.88 Typical High $20,892.96 | Facility | None | $239.88 | $4,570.88 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $389.05 | Professional | None | $190.55 | $239.88 | $389.05 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $162.18 Median $1,148.15 Typical High $12,022.64 | Facility | None | $162.18 | $1,148.15 | $12,022.64 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $281.84 Median $1,479.11 Typical High $1,548.82 | Professional | None | $281.84 | $1,479.11 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $2,187.76 Typical High $4,073.80 | Facility | None | $467.74 | $2,187.76 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $588.84 | Professional | None | $218.78 | $251.19 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $512.86 Typical High $3,630.78 | Professional | None | $263.03 | $512.86 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $257.04 Typical High $436.52 | Professional | None | $44.67 | $257.04 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $398.11 | Facility | None | $229.09 | $363.08 | $398.11 |
Premera BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,548.82 Typical High $2,818.38 | Facility | None | $741.31 | $1,548.82 | $2,818.38 |
Premera BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $9,120.11 Typical High $17,378.01 | Facility | None | $6,025.60 | $9,120.11 | $17,378.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $562.34 | Professional | None | $281.84 | $398.11 | $562.34 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $12,589.25 | Facility | None | $1,202.26 | $1,949.84 | $12,589.25 |
United Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $630.96 | Professional | None | $239.88 | $338.84 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $380.19 | Professional | None | $245.47 | $257.04 | $380.19 |
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 $120.23 | Professional | 52 · Reduced service | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $169.82 |
Where Washington sits
The same service costs 7.6 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,667MT $611
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.