How much rates vary
Facilitymedian $347 · 10th to 90th $155 to $2,138Professionalmedian $302 · 10th to 90th $72 to $562
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 $302.00 Median $6,165.95 Typical High $20,892.96 | Facility | None | $302.00 | $6,165.95 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $331.13 | Professional | None | $144.54 | $213.80 | $331.13 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $95.50 Median $1,479.11 Typical High $3,019.95 | Facility | None | $95.50 | $1,479.11 | $3,019.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $1,862.09 | Professional | None | $208.93 | $467.74 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $426.58 Typical High $1,000.00 | Facility | None | $223.87 | $426.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $562.34 | Professional | None | $158.49 | $263.03 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $537.03 | Professional | None | $194.98 | $323.59 | $537.03 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $309.03 Typical High $549.54 | Professional | None | $57.54 | $309.03 | $549.54 |
Pacific Source Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $426.58 | Facility | None | $239.88 | $407.38 | $426.58 |
Premera BCBS Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $309.03 | Facility | None | $151.36 | $190.55 | $309.03 |
Premera BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $295.12 | Professional | None | $190.55 | $190.55 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $3,019.95 | Facility | None | $1,230.27 | $1,621.81 | $3,019.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $524.81 | Professional | None | $186.21 | $309.03 | $524.81 |
United Setting Facility Modifier None Typical Low $134.90 Median $346.74 Typical High $2,137.96 | Facility | None | $134.90 | $346.74 | $2,137.96 |
United Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $575.44 | Professional | None | $173.78 | $295.12 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $316.23 | Professional | None | $173.78 | $269.15 | $316.23 |
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 $91.20 Median $107.15 Typical High $151.36 | Professional | 52 · Reduced service | $91.20 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $43.65 Typical High $60.26 | Professional | 53 · Discontinued | $36.31 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $229.09 | Professional | 54 · Surgery only | $134.90 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.20 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $151.36 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $125.89 | $151.36 | $213.80 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,819.70 Median $2,398.83 Typical High $4,570.88 | Facility | 50 · Both sides | $1,819.70 | $2,398.83 | $4,570.88 |
Where Washington sits
The same service costs 3.5 times more in Wisconsin 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· 11th of 51
$302
WI $575KY $162
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.