How much rates vary
Facilitymedian $8,913 · 10th to 90th $7,244 to $14,454Professionalmedian $8,913 · 10th to 90th $4,786 to $25,119
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 $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $6,165.95 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,165.95 | $6,606.93 | $6,606.93 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $7,244.36 Median $8,709.64 Typical High $10,000.00 | Facility | None | $7,244.36 | $8,709.64 | $10,000.00 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $8,912.51 Median $52,480.75 Typical High $75,857.76 | Professional | None | $8,912.51 | $52,480.75 | $75,857.76 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,025.60 | Facility | None | $5,623.41 | $5,623.41 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Kaiser Permanente Setting Facility Modifier None Typical Low $9,772.37 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,772.37 | $12,302.69 | $18,620.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9,772.37 Median $12,589.25 Typical High $20,417.38 | Professional | None | $9,772.37 | $12,589.25 | $20,417.38 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,232.93 | Facility | None | $10,000.00 | $10,000.00 | $10,232.93 |
Premera BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Facility | None | $8,912.51 | $8,912.51 | $8,912.51 |
Premera BCBS Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $10,000.00 | Professional | None | $8,511.38 | $8,511.38 | $10,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $8,317.64 Median $8,912.51 Typical High $10,964.78 | Professional | None | $8,317.64 | $8,912.51 | $10,964.78 |
United Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $8,912.51 | Professional | None | $4,570.88 | $4,570.88 | $8,912.51 |
Wellpoint Setting Professional Modifier None Typical Low $4,897.79 Median $7,244.36 Typical High $15,488.17 | Professional | None | $4,897.79 | $7,244.36 | $15,488.17 |
4 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 $3,090.30 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $3,090.30 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $1,230.27 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $933.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $616.60 | $660.69 | $660.69 |
Where Washington sits
The same service costs 2.6 times more in Montana than in New York. 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· 7th of 51
$8,913
MT $10,715NY $4,169
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.