How much rates vary
Facilitymedian $17,378 · 10th to 90th $14,791 to $30,200Professionalmedian $15,136 · 10th to 90th $8,511 to $43,652
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 $11,481.54 Median $11,481.54 Typical High $11,481.54 | Facility | None | $11,481.54 | $11,481.54 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $10,715.19 Median $11,481.54 Typical High $11,481.54 | Professional | None | $10,715.19 | $11,481.54 | $11,481.54 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $14,125.38 Median $16,982.44 Typical High $19,054.61 | Facility | None | $14,125.38 | $16,982.44 | $19,054.61 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $15,135.61 Median $114,815.36 Typical High $128,824.96 | Professional | None | $15,135.61 | $114,815.36 | $128,824.96 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,882.50 | Facility | None | $11,748.98 | $11,748.98 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $11,748.98 | Professional | None | $8,511.38 | $8,511.38 | $11,748.98 |
Kaiser Permanente Setting Facility Modifier None Typical Low $16,982.44 Median $21,379.62 Typical High $31,622.78 | Facility | None | $16,982.44 | $21,379.62 | $31,622.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16,218.10 Median $21,877.62 Typical High $38,018.94 | Professional | None | $16,218.10 | $21,877.62 | $38,018.94 |
Molina Setting Professional Modifier None Typical Low $5,011.87 Median $13,489.63 Typical High $14,791.08 | Professional | None | $5,011.87 | $13,489.63 | $14,791.08 |
Pacific Source Setting Facility Modifier None Typical Low $17,378.01 Median $17,782.79 Typical High $20,892.96 | Facility | None | $17,378.01 | $17,782.79 | $20,892.96 |
Premera BCBS Setting Facility Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $34,673.69 | Facility | None | $15,488.17 | $15,488.17 | $34,673.69 |
Premera BCBS Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $16,982.44 | Professional | None | $14,791.08 | $14,791.08 | $16,982.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $17,378.01 | Facility | None | $17,378.01 | $17,378.01 | $17,378.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $14,454.40 Median $15,135.61 Typical High $19,054.61 | Professional | None | $14,454.40 | $15,135.61 | $19,054.61 |
United Setting Facility Modifier None Typical Low $8,912.51 Median $27,542.29 Typical High $27,542.29 | Facility | None | $8,912.51 | $27,542.29 | $27,542.29 |
United Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $16,595.87 | Professional | None | $8,511.38 | $8,511.38 | $16,595.87 |
Wellpoint Setting Professional Modifier None Typical Low $10,232.93 Median $12,589.25 Typical High $26,915.35 | Professional | None | $10,232.93 | $12,589.25 | $26,915.35 |
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 $5,370.32 Median $5,754.40 Typical High $5,754.40 | Professional | 52 · Reduced service | $5,370.32 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,137.96 Median $2,290.87 Typical High $2,290.87 | Professional | 53 · Discontinued | $2,137.96 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | 55 · Aftercare only | $1,621.81 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $1,071.52 | $1,148.15 | $1,148.15 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Facility | NR · New when rented | $15,488.17 | $15,488.17 | $15,488.17 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $14,791.08 Median $14,791.08 Typical High $16,982.44 | Professional | NR · New when rented | $14,791.08 | $14,791.08 | $16,982.44 |
Where Washington sits
The same service costs 2.6 times more in Montana than in New Jersey. 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
$15,488
MT $21,878NJ $8,511
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.