How much rates vary
Facilitymedian $9,120 · 10th to 90th $7,762 to $15,849Professionalmedian $8,128 · 10th to 90th $4,786 to $20,417
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 $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $5,623.41 Median $6,025.60 Typical High $6,025.60 | Professional | None | $5,623.41 | $6,025.60 | $6,025.60 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $6,918.31 Median $9,120.11 Typical High $9,332.54 | Facility | None | $6,918.31 | $9,120.11 | $9,332.54 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $8,128.31 Median $48,977.88 Typical High $61,659.50 | Professional | None | $8,128.31 | $48,977.88 | $61,659.50 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,079.46 | Facility | None | $6,606.93 | $6,606.93 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
Kaiser Permanente Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $16,982.44 | Facility | None | $8,912.51 | $11,220.18 | $16,982.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8,511.38 Median $11,481.54 Typical High $17,782.79 | Professional | None | $8,511.38 | $11,481.54 | $17,782.79 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $7,079.46 Typical High $7,943.28 | Professional | None | $5,011.87 | $7,079.46 | $7,943.28 |
Pacific Source Setting Facility Modifier None Typical Low $9,120.11 Median $9,332.54 Typical High $9,772.37 | Facility | None | $9,120.11 | $9,332.54 | $9,772.37 |
Premera BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $18,197.01 | Facility | None | $8,128.31 | $8,128.31 | $18,197.01 |
Premera BCBS Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $9,120.11 | Professional | None | $7,762.47 | $7,762.47 | $9,120.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,585.78 Median $8,128.31 Typical High $10,000.00 | Professional | None | $7,585.78 | $8,128.31 | $10,000.00 |
United Setting Facility Modifier None Typical Low $4,466.84 Median $13,182.57 Typical High $13,182.57 | Facility | None | $4,466.84 | $13,182.57 | $13,182.57 |
United Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $7,762.47 | Professional | None | $3,981.07 | $3,981.07 | $7,762.47 |
Wellpoint Setting Professional Modifier None Typical Low $4,897.79 Median $6,606.93 Typical High $14,454.40 | Professional | None | $4,897.79 | $6,606.93 | $14,454.40 |
6 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 $2,818.38 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $2,818.38 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $1,148.15 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $851.14 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $562.34 | $602.56 | $602.56 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | NR · New when rented | $8,128.31 | $8,128.31 | $8,128.31 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $7,762.47 Median $7,762.47 Typical High $9,120.11 | Professional | NR · New when rented | $7,762.47 | $7,762.47 | $9,120.11 |
Where Washington sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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
$8,128
MT $10,000PA $4,786
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.