How much rates vary
Facilitymedian $174 · 10th to 90th $74 to $234Professionalmedian $126 · 10th to 90th $85 to $200
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $109.65 Median $112.20 Typical High $186.21 | Facility | None | $109.65 | $112.20 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $154.88 | Professional | None | $109.65 | $112.20 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $199.53 | Professional | None | $79.43 | $125.89 | $199.53 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $56.23 Median $173.78 Typical High $245.47 | Facility | None | $56.23 | $173.78 | $245.47 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $724.44 | Professional | None | $117.49 | $158.49 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $199.53 | Professional | None | $91.20 | $123.03 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $223.87 | Professional | None | $74.13 | $117.49 | $223.87 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $131.83 | Professional | None | $64.57 | $91.20 | $131.83 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $190.55 Typical High $229.09 | Facility | None | $81.28 | $190.55 | $229.09 |
Premera BCBS Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $169.82 | Facility | None | $154.88 | $154.88 | $169.82 |
Premera BCBS Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | None | $125.89 | $169.82 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $162.18 Median $173.78 Typical High $245.47 | Facility | None | $162.18 | $173.78 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $204.17 | Professional | None | $117.49 | $158.49 | $204.17 |
United Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $223.87 | Professional | None | $104.71 | $141.25 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $173.78 | Professional | None | $75.86 | $125.89 | $173.78 |
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 $56.23 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $15.49 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 24 · Unrelated visit after surgery | $67.61 | $67.61 | $67.61 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $87.10 Median $117.49 Typical High $199.53 | Professional | 25 · Same-day visit | $87.10 | $117.49 | $199.53 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | FP · Family planning | $75.86 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | KX · Policy requirements met | $95.50 | $95.50 | $95.50 |
Where Washington sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 18th of 51
$126
AK $224DC $83.18
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.