How much rates vary
Facilitymedian $912 · 10th to 90th $912 to $912Professionalmedian $47 · 10th to 90th $3 to $708
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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $831.76 | Professional | None | $30.20 | $30.20 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $3.16 Median $3.31 Typical High $4.17 | Professional | None | $3.16 | $3.31 | $4.17 |
CareFirst Setting Professional Modifier NA Typical Low $2.95 Median $3.09 Typical High $4.68 | Professional | NA | $2.95 | $3.09 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $954.99 | Professional | None | $416.87 | $645.65 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $933.25 | Professional | None | $363.08 | $676.08 | $933.25 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $398.11 Median $741.31 Typical High $1,023.29 | Professional | P3 · Severe systemic disease | $398.11 | $741.31 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $426.58 Median $812.83 Typical High $1,096.48 | Professional | P4 · Life-threatening disease | $426.58 | $812.83 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $467.74 Median $870.96 Typical High $1,202.26 | Professional | P5 · Not expected to survive without surgery | $467.74 | $870.96 | $1,202.26 |