How much rates vary
Facilitymedian $501 · 10th to 90th $186 to $8,913Professionalmedian $224 · 10th to 90th $41 to $457
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 $223.87 Median $3,981.07 Typical High $20,417.38 | Facility | None | $223.87 | $3,981.07 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $389.05 | Professional | None | $177.83 | $239.88 | $389.05 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $97.72 Median $6,309.57 Typical High $12,882.50 | Facility | None | $97.72 | $6,309.57 | $12,882.50 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $194.98 Median $630.96 Typical High $2,398.83 | Professional | None | $194.98 | $630.96 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $446.68 Typical High $630.96 | Facility | None | $234.42 | $446.68 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $457.09 | Professional | None | $147.91 | $251.19 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $537.03 | Professional | None | $186.21 | $281.84 | $537.03 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $199.53 Typical High $416.87 | Professional | None | $38.02 | $199.53 | $416.87 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $478.63 | Facility | None | $269.15 | $426.58 | $478.63 |
Premera BCBS Setting Facility Modifier None Typical Low $141.25 Median $199.53 Typical High $323.59 | Facility | None | $141.25 | $199.53 | $323.59 |
Premera BCBS Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | None | $204.17 | $323.59 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $12,882.50 | Facility | None | $4,570.88 | $6,760.83 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $501.19 | Professional | None | $194.98 | $323.59 | $501.19 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $9,332.54 | Facility | None | $1,202.26 | $1,949.84 | $9,332.54 |
United Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $537.03 | Professional | None | $186.21 | $302.00 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $177.83 Typical High $346.74 | Professional | None | $30.90 | $177.83 | $346.74 |
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 $112.20 Median $114.82 Typical High $190.55 | Professional | 52 · Reduced service | $112.20 | $114.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $75.86 | Professional | 53 · Discontinued | $44.67 | $45.71 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | 54 · Surgery only | $169.82 | $169.82 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $56.23 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $263.03 |
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 4.2 times more in Wyoming 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· 38th of 51
$224
WY $692UT $166
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.