How much rates vary
Facilitymedian $724 · 10th to 90th $91 to $11,482Professionalmedian $219 · 10th to 90th $47 to $407
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 $194.98 Median $6,165.95 Typical High $20,892.96 | Facility | None | $194.98 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $204.17 | Professional | None | $131.83 | $147.91 | $204.17 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $75.86 Median $8,317.64 Typical High $17,378.01 | Facility | None | $75.86 | $8,317.64 | $17,378.01 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $169.82 Median $346.74 Typical High $1,412.54 | Professional | None | $169.82 | $346.74 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $234.42 Typical High $1,000.00 | Facility | None | $123.03 | $234.42 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $426.58 | Professional | None | $134.90 | $173.78 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $371.54 | Professional | None | $125.89 | $229.09 | $371.54 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $218.78 Typical High $407.38 | Professional | None | $42.66 | $218.78 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $288.40 Typical High $323.59 | Facility | None | $165.96 | $288.40 | $323.59 |
Premera BCBS Setting Facility Modifier None Typical Low $56.23 Median $102.33 Typical High $194.98 | Facility | None | $56.23 | $102.33 | $194.98 |
Premera BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | None | $154.88 | $154.88 | $229.09 |
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 $154.88 Median $251.19 Typical High $398.11 | Professional | None | $154.88 | $251.19 | $398.11 |
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 $147.91 Median $223.87 Typical High $436.52 | Professional | None | $147.91 | $223.87 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $234.42 | Professional | None | $138.04 | $208.93 | $234.42 |
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 $66.07 Median $72.44 Typical High $97.72 | Professional | 52 · Reduced service | $66.07 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $26.30 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $107.15 Typical High $147.91 | Professional | 54 · Surgery only | $100.00 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $29.51 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.18 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $100.00 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $93.33 | $100.00 | $138.04 |
Where Washington sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 12th of 51
$224
WI $468TX $129
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.