How much rates vary
Facilitymedian $145 · 10th to 90th $56 to $871Professionalmedian $151 · 10th to 90th $62 to $288
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 $74.13 Median $1,737.80 Typical High $17,378.01 | Facility | None | $74.13 | $1,737.80 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $165.96 | Professional | None | $74.13 | $109.65 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $199.53 | Professional | None | $87.10 | $151.36 | $199.53 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $41.69 Median $524.81 Typical High $1,096.48 | Facility | None | $41.69 | $524.81 | $1,096.48 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $851.14 | Professional | None | $95.50 | $218.78 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $81.28 Typical High $134.90 | Facility | None | $58.88 | $81.28 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $263.03 | Professional | None | $102.33 | $131.83 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $141.25 Typical High $251.19 | Professional | None | $74.13 | $141.25 | $251.19 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $169.82 Typical High $288.40 | Professional | None | $29.51 | $169.82 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $186.21 Typical High $208.93 | Facility | None | $117.49 | $186.21 | $208.93 |
Premera BCBS Setting Facility Modifier None Typical Low $46.77 Median $64.57 Typical High $112.20 | Facility | None | $46.77 | $64.57 | $112.20 |
Premera BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $141.25 | Professional | None | $87.10 | $87.10 | $141.25 |
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 $87.10 Median $147.91 Typical High $245.47 | Professional | None | $87.10 | $147.91 | $245.47 |
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 $87.10 Median $144.54 Typical High $269.15 | Professional | None | $87.10 | $144.54 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $141.25 | Professional | None | $74.13 | $109.65 | $141.25 |
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 $37.15 Median $45.71 Typical High $61.66 | Professional | 52 · Reduced service | $37.15 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.20 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $67.61 Typical High $93.33 | Professional | 54 · Surgery only | $54.95 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $18.62 | Professional | 55 · Aftercare only | $10.96 | $13.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.12 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $9.12 | $12.30 |
Where Washington sits
The same service costs 3.0 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.
Washington· 10th of 51
$151
WI $282KY $93.33
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.