How much rates vary
Facilitymedian $562 · 10th to 90th $45 to $3,388Professionalmedian $339 · 10th to 90th $47 to $661
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 $44.67 Median $512.86 Typical High $707.95 | Facility | None | $44.67 | $512.86 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $645.65 | Professional | None | $44.67 | $56.23 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $691.83 | Professional | None | $204.17 | $346.74 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $676.08 | Professional | None | $354.81 | $467.74 | $676.08 |
Denver HMP Setting Facility Modifier None Typical Low $1,905.46 Median $3,388.44 Typical High $3,630.78 | Facility | None | $1,905.46 | $3,388.44 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $758.58 | Professional | None | $398.11 | $537.03 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $758.58 | Professional | None | $446.68 | $562.34 | $758.58 |
United Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $95.50 | Professional | None | $39.81 | $66.07 | $95.50 |
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 $446.68 Median $602.56 Typical High $851.14 | Professional | P3 · Severe systemic disease | $446.68 | $602.56 | $851.14 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $501.19 Median $676.08 Typical High $954.99 | Professional | P4 · Life-threatening disease | $501.19 | $676.08 | $954.99 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $549.54 Median $741.31 Typical High $1,047.13 | Professional | P5 · Not expected to survive without surgery | $549.54 | $741.31 | $1,047.13 |