How much rates vary
Facilitymedian $3,236 · 10th to 90th $955 to $17,783Professionalmedian $832 · 10th to 90th $65 to $1,820
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 $1,122.02 Median $10,232.93 Typical High $25,118.86 | Facility | None | $1,122.02 | $10,232.93 | $25,118.86 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | None | $977.24 | $977.24 | $1,122.02 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $549.54 Median $13,182.57 Typical High $27,542.29 | Facility | None | $549.54 | $13,182.57 | $27,542.29 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,148.15 Median $6,025.60 Typical High $6,309.57 | Professional | None | $1,148.15 | $6,025.60 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $7,244.36 | Facility | None | $707.95 | $3,890.45 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $2,398.83 | Professional | None | $954.99 | $1,047.13 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $6,025.60 | Professional | None | $1,148.15 | $2,041.74 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $707.95 Typical High $1,737.80 | Professional | None | $63.10 | $707.95 | $1,737.80 |
Pacific Source Setting Facility Modifier None Typical Low $933.25 Median $1,584.89 Typical High $1,659.59 | Facility | None | $933.25 | $1,584.89 | $1,659.59 |
Premera BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $3,801.89 | Facility | None | $1,621.81 | $2,290.87 | $3,801.89 |
Premera BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,000.00 Median $14,454.40 Typical High $27,542.29 | Facility | None | $10,000.00 | $14,454.40 | $27,542.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,659.59 | $2,344.23 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $3,548.13 Typical High $19,498.45 | Facility | None | $2,089.30 | $3,548.13 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,412.54 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,047.13 | $1,513.56 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Washington sits
The same service costs 4.7 times more in Wisconsin 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.
Physician feeFacility fee
WI $10,274KY $2,189
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.