How much rates vary
Facilitymedian $1,950 · 10th to 90th $832 to $6,166Professionalmedian $525 · 10th to 90th $129 to $1,549
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 $891.25 Median $11,220.18 Typical High $21,877.62 | Facility | None | $891.25 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | None | $851.14 | $891.25 | $891.25 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $549.54 Typical High $5,011.87 | Facility | None | $30.20 | $549.54 | $5,011.87 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,122.02 Median $5,754.40 Typical High $6,456.54 | Professional | None | $1,122.02 | $5,754.40 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $2,691.53 | Facility | None | $707.95 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $2,344.23 | Professional | None | $933.25 | $1,047.13 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,659.59 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $478.63 Typical High $1,445.44 | Professional | None | $125.89 | $478.63 | $1,445.44 |
Pacific Source Setting Facility Modifier None Typical Low $912.01 Median $1,548.82 Typical High $1,621.81 | Facility | None | $912.01 | $1,548.82 | $1,621.81 |
Premera BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,122.02 | Facility | None | $1,096.48 | $1,096.48 | $1,122.02 |
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 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 $1,479.11 Median $2,398.83 Typical High $4,897.79 | Facility | None | $1,479.11 | $2,398.83 | $4,897.79 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,570.40 | Professional | None | $977.24 | $1,380.38 | $2,570.40 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,479.11 | Professional | None | $977.24 | $1,023.29 | $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 $426.58 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $630.96 |
Where Washington sits
The same service costs 8.5 times more in Oklahoma 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· 49th of 51
$550
OK $3,162TX $372
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.