How much rates vary
Facilitymedian $398 · 10th to 90th $98 to $2,754Professionalmedian $251 · 10th to 90th $158 to $490
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 $229.09 Median $5,128.61 Typical High $20,892.96 | Facility | None | $229.09 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $229.09 | Professional | None | $162.18 | $194.98 | $229.09 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $87.10 Median $1,949.84 Typical High $3,981.07 | Facility | None | $87.10 | $1,949.84 | $3,981.07 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $1,659.59 | Professional | None | $181.97 | $338.84 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $223.87 Typical High $870.96 | Facility | None | $131.83 | $223.87 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $346.74 | Professional | None | $165.96 | $208.93 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $398.11 | Professional | None | $125.89 | $204.17 | $398.11 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $288.40 Typical High $489.78 | Professional | None | $79.43 | $288.40 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $354.81 | Facility | None | $245.47 | $338.84 | $354.81 |
Premera BCBS Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $194.98 | Facility | None | $69.18 | $109.65 | $194.98 |
Premera BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $251.19 | Professional | None | $181.97 | $181.97 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $3,801.89 | Facility | None | $1,348.96 | $2,041.74 | $3,801.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $380.19 | Professional | None | $181.97 | $251.19 | $380.19 |
United Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $2,754.23 | Facility | None | $371.54 | $691.83 | $2,754.23 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $416.87 | Professional | None | $165.96 | $234.42 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $269.15 | Professional | None | $114.82 | $190.55 | $269.15 |
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 $81.28 Median $87.10 Typical High $114.82 | Professional | 52 · Reduced service | $81.28 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $34.67 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $131.83 Typical High $169.82 | Professional | 54 · Surgery only | $123.03 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $26.30 Typical High $34.67 | Professional | 55 · Aftercare only | $24.55 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $22.91 |
Where Washington sits
The same service costs 3.6 times more in Alaska 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· 12th of 51
$251
AK $537KY $148
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.