How much rates vary
Facilitymedian $174 · 10th to 90th $93 to $224Professionalmedian $191 · 10th to 90th $129 to $331
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 $93.33 Median $169.82 Typical High $218.78 | Facility | None | $93.33 | $169.82 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $218.78 | Professional | None | $93.33 | $169.82 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $302.00 | Professional | None | $151.36 | $199.53 | $302.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $234.42 | Facility | None | $87.10 | $87.10 | $234.42 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $1,047.13 | Professional | None | $181.97 | $223.87 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Facility | None | $125.89 | $125.89 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $275.42 | Professional | None | $128.82 | $177.83 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $323.59 | Professional | None | $107.15 | $169.82 | $323.59 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $398.11 | Professional | None | $120.23 | $208.93 | $398.11 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $331.13 | Facility | None | $257.04 | $302.00 | $331.13 |
Premera BCBS Setting Facility Modifier None Typical Low $218.78 Median $223.87 Typical High $223.87 | Facility | None | $218.78 | $223.87 | $223.87 |
Premera BCBS Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | None | $173.78 | $218.78 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $371.54 | Facility | None | $295.12 | $295.12 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $295.12 | Professional | None | $181.97 | $223.87 | $295.12 |
United Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $309.03 | Professional | None | $154.88 | $204.17 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $257.04 | Professional | None | $117.49 | $181.97 | $257.04 |
9 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 $74.13 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $74.13 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $22.39 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.79 | $15.49 | $19.05 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 24 · Unrelated visit after surgery | $398.11 | $398.11 | $398.11 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $151.36 Median $199.53 Typical High $316.23 | Professional | 25 · Same-day visit | $151.36 | $199.53 | $316.23 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $251.19 Median $346.74 Typical High $398.11 | Professional | 57 · Decision for surgery | $251.19 | $346.74 | $398.11 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | FS · Shared visit | $117.49 | $117.49 | $117.49 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $204.17 Median $302.00 Typical High $346.74 | Professional | GC · Resident with teaching physician | $204.17 | $302.00 | $346.74 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | TH · Pregnancy care | $257.04 | $263.03 | $309.03 |
Where Washington sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 13th of 51
$191
AK $263AL $115
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.