How much rates vary
Facilitymedian $126 · 10th to 90th $43 to $776Professionalmedian $102 · 10th to 90th $42 to $200
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 $53.70 Median $144.54 Typical High $21,877.62 | Facility | None | $53.70 | $144.54 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $114.82 | Professional | None | $48.98 | $79.43 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | None | $77.62 | $114.82 | $114.82 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $537.03 Typical High $1,096.48 | Facility | None | $30.20 | $537.03 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $602.56 | Professional | None | $69.18 | $162.18 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $57.54 Typical High $95.50 | Facility | None | $46.77 | $57.54 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $181.97 | Professional | None | $54.95 | $89.13 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $97.72 Typical High $177.83 | Professional | None | $52.48 | $97.72 | $177.83 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $112.20 Typical High $194.98 | Professional | None | $19.50 | $112.20 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $131.83 Typical High $144.54 | Facility | None | $112.20 | $131.83 | $144.54 |
Premera BCBS Setting Facility Modifier None Typical Low $38.02 Median $47.86 Typical High $83.18 | Facility | None | $38.02 | $47.86 | $83.18 |
Premera BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $102.33 | Professional | None | $63.10 | $63.10 | $102.33 |
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 $61.66 Median $102.33 Typical High $181.97 | Professional | None | $61.66 | $102.33 | $181.97 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $831.76 | Facility | None | $134.90 | $346.74 | $831.76 |
United Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $194.98 | Professional | None | $60.26 | $100.00 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $100.00 | Professional | None | $53.70 | $81.28 | $100.00 |
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 $26.92 Median $32.36 Typical High $43.65 | Professional | 52 · Reduced service | $26.92 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.88 Typical High $17.78 | Professional | 53 · Discontinued | $10.72 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $48.98 Typical High $66.07 | Professional | 54 · Surgery only | $39.81 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.77 Typical High $13.18 | Professional | 55 · Aftercare only | $8.13 | $9.77 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.37 | $6.46 | $8.71 |
Where Washington sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$102
WI $200DC $64.57
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.