How much rates vary
Facilitymedian $832 · 10th to 90th $45 to $3,388Professionalmedian $513 · 10th to 90th $47 to $977
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 $776.25 Typical High $1,071.52 | Facility | None | $44.67 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $954.99 | Professional | None | $44.67 | $56.23 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $1,023.29 | Professional | None | $302.00 | $512.86 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,071.52 | Professional | None | $562.34 | $741.31 | $1,071.52 |
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 $602.56 Median $812.83 Typical High $1,148.15 | Professional | None | $602.56 | $812.83 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,148.15 | Professional | None | $660.69 | $831.76 | $1,148.15 |
United Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $95.50 | Professional | None | $39.81 | $66.07 | $95.50 |
4 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.91 Typical High $9.55 | Professional | 53 · Discontinued | $8.51 | $8.91 | $9.55 |
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $645.65 Median $870.96 Typical High $1,230.27 | Professional | P3 · Severe systemic disease | $645.65 | $870.96 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $707.95 Median $933.25 Typical High $1,318.26 | Professional | P4 · Life-threatening disease | $707.95 | $933.25 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $758.58 Median $1,000.00 Typical High $1,412.54 | Professional | P5 · Not expected to survive without surgery | $758.58 | $1,000.00 | $1,412.54 |