How much rates vary
Facilitymedian $407 · 10th to 90th $407 to $407Professionalmedian $52 · 10th to 90th $3 to $309
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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $371.54 | Professional | None | $30.20 | $30.20 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $3.09 Median $3.47 Typical High $5.37 | Professional | None | $3.09 | $3.47 | $5.37 |
CareFirst Setting Professional Modifier NA Typical Low $2.95 Median $3.16 Typical High $3.72 | Professional | NA | $2.95 | $3.16 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $380.19 | Professional | None | $169.82 | $257.04 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $426.58 | Professional | None | $165.96 | $309.03 | $426.58 |
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 $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $199.53 Median $371.54 Typical High $512.86 | Professional | P3 · Severe systemic disease | $199.53 | $371.54 | $512.86 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $229.09 Median $436.52 Typical High $602.56 | Professional | P4 · Life-threatening disease | $229.09 | $436.52 | $602.56 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $263.03 Median $501.19 Typical High $676.08 | Professional | P5 · Not expected to survive without surgery | $263.03 | $501.19 | $676.08 |