How much rates vary
Facilitymedian $1,318 · 10th to 90th $417 to $8,511Professionalmedian $224 · 10th to 90th $126 to $427
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 $309.03 Median $5,128.61 Typical High $20,892.96 | Facility | None | $309.03 | $5,128.61 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $316.23 | Professional | None | $199.53 | $251.19 | $316.23 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $85.11 Median $812.83 Typical High $8,912.51 | Facility | None | $85.11 | $812.83 | $8,912.51 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $173.78 Median $537.03 Typical High $1,698.24 | Professional | None | $173.78 | $537.03 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,659.59 Typical High $2,951.21 | Facility | None | $467.74 | $1,659.59 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $380.19 | Professional | None | $131.83 | $208.93 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $501.19 Typical High $2,238.72 | Professional | None | $177.83 | $501.19 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $389.05 | Professional | None | $112.20 | $218.78 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $398.11 | Facility | None | $223.87 | $354.81 | $398.11 |
Premera BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,258.93 Typical High $2,137.96 | Facility | None | $549.54 | $1,258.93 | $2,137.96 |
Premera BCBS Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $269.15 | Professional | None | $177.83 | $269.15 | $269.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,466.84 Median $6,760.83 Typical High $12,882.50 | Facility | None | $4,466.84 | $6,760.83 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $416.87 | Professional | None | $173.78 | $269.15 | $416.87 |
United Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $8,912.51 | Facility | None | $588.84 | $977.24 | $8,912.51 |
United Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $446.68 | Professional | None | $165.96 | $251.19 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $26.30 Median $158.49 Typical High $288.40 | Professional | None | $26.30 | $158.49 | $288.40 |
7 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 $100.00 Median $100.00 Typical High $154.88 | Professional | 52 · Reduced service | $100.00 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $40.74 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $40.74 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $151.36 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $46.77 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $141.25 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $141.25 | $218.78 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,760.83 Median $10,232.93 Typical High $19,498.45 | Facility | 50 · Both sides | $6,760.83 | $10,232.93 | $19,498.45 |
Where Washington sits
The same service costs 4.7 times more in Alaska 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· 20th of 51
$234
AK $708UT $151
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.