How much rates vary
Facilitymedian $1,148 · 10th to 90th $1,148 to $1,148Professionalmedian $52 · 10th to 90th $3 to $933
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $1,047.13 | Professional | None | $30.20 | $30.20 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.07 | Professional | None | $2.95 | $2.95 | $4.07 |
CareFirst Setting Professional Modifier NA Typical Low $3.02 Median $3.31 Typical High $4.68 | Professional | NA | $3.02 | $3.31 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,258.93 | Professional | None | $549.54 | $851.14 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $870.96 Typical High $1,202.26 | Professional | None | $467.74 | $870.96 | $1,202.26 |
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 $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $501.19 Median $933.25 Typical High $1,288.25 | Professional | P3 · Severe systemic disease | $501.19 | $933.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $524.81 Median $1,000.00 Typical High $1,348.96 | Professional | P4 · Life-threatening disease | $524.81 | $1,000.00 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $562.34 Median $1,047.13 Typical High $1,445.44 | Professional | P5 · Not expected to survive without surgery | $562.34 | $1,047.13 | $1,445.44 |