How much rates vary
Facilitymedian $575 · 10th to 90th $575 to $575Professionalmedian $44 · 10th to 90th $3 to $282
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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $524.81 | Professional | None | $30.20 | $30.20 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $3.09 Median $3.31 Typical High $4.07 | Professional | None | $3.09 | $3.31 | $4.07 |
CareFirst Setting Professional Modifier NA Typical Low $2.95 Median $3.16 Typical High $4.57 | Professional | NA | $2.95 | $3.16 | $4.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $602.56 | Professional | None | $229.09 | $436.52 | $602.56 |
United Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $89.13 | Professional | None | $44.67 | $54.95 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
3 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 |
|---|---|---|---|---|---|
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $263.03 Median $501.19 Typical High $676.08 | Professional | P3 · Severe systemic disease | $263.03 | $501.19 | $676.08 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $295.12 Median $562.34 Typical High $776.25 | Professional | P4 · Life-threatening disease | $295.12 | $562.34 | $776.25 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $331.13 Median $616.60 Typical High $851.14 | Professional | P5 · Not expected to survive without surgery | $331.13 | $616.60 | $851.14 |