How much rates vary
Facilitymedian $977 · 10th to 90th $977 to $977Professionalmedian $47 · 10th to 90th $3 to $776
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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $891.25 | Professional | None | $30.20 | $30.20 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.17 | Professional | None | $3.31 | $3.31 | $4.17 |
CareFirst Setting Professional Modifier NA Typical Low $2.95 Median $3.09 Typical High $4.79 | Professional | NA | $2.95 | $3.09 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,047.13 | Professional | None | $457.09 | $707.95 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $1,023.29 | Professional | None | $398.11 | $741.31 | $1,023.29 |
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 $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $426.58 Median $812.83 Typical High $1,096.48 | Professional | P3 · Severe systemic disease | $426.58 | $812.83 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $467.74 Median $870.96 Typical High $1,202.26 | Professional | P4 · Life-threatening disease | $467.74 | $870.96 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $501.19 Median $933.25 Typical High $1,288.25 | Professional | P5 · Not expected to survive without surgery | $501.19 | $933.25 | $1,288.25 |