How much rates vary
Facilitymedian $5,495 · 10th to 90th $955 to $35,481Professionalmedian $871 · 10th to 90th $141 to $1,738
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 $954.99 Median $14,125.38 Typical High $56,234.13 | Facility | None | $954.99 | $14,125.38 | $56,234.13 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,122.02 | Professional | None | $831.76 | $954.99 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $537.03 Median $28,840.32 Typical High $58,884.37 | Facility | None | $537.03 | $28,840.32 | $58,884.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,122.02 Median $5,888.44 Typical High $6,165.95 | Professional | None | $1,122.02 | $5,888.44 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,456.54 Typical High $12,022.64 | Facility | None | $707.95 | $6,456.54 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $2,344.23 | Professional | None | $954.99 | $1,047.13 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $10,715.19 | Professional | None | $1,202.26 | $2,041.74 | $10,715.19 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $794.33 Typical High $1,659.59 | Professional | None | $134.90 | $794.33 | $1,659.59 |
Pacific Source Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $1,621.81 | Facility | None | $954.99 | $1,513.56 | $1,621.81 |
Premera BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $5,128.61 Typical High $8,912.51 | Facility | None | $3,801.89 | $5,128.61 | $8,912.51 |
Premera BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $20,417.38 Median $30,199.52 Typical High $57,543.99 | Facility | None | $20,417.38 | $30,199.52 | $57,543.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,621.81 | $2,238.72 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $4,677.35 Typical High $41,686.94 | Facility | None | $2,754.23 | $4,677.35 | $41,686.94 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,380.38 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,479.11 | Professional | None | $977.24 | $1,000.00 | $1,479.11 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Washington sits
The same service costs 11.0 times more in Oklahoma than in Utah. 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· 43rd of 51
$891
OK $5,888UT $537
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.