How much rates vary
Facilitymedian $41 · 10th to 90th $38 to $2,754Professionalmedian $851 · 10th to 90th $427 to $3,311
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 $38.02 Median $40.74 Typical High $2,754.23 | Facility | None | $38.02 | $40.74 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $1,445.44 | Professional | None | $38.02 | $40.74 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,778.28 | Professional | None | $758.58 | $831.76 | $1,778.28 |
Blue Shield Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,047.13 | Professional | None | $602.56 | $870.96 | $1,047.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $19.50 Median $25.12 Typical High $25.12 | Professional | None | $19.50 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,819.70 | Professional | None | $831.76 | $1,148.15 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $588.84 | Professional | None | $288.40 | $426.58 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $2,089.30 | Professional | None | $489.78 | $794.33 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,621.81 | Professional | None | $758.58 | $1,148.15 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $112.20 | Professional | None | $52.48 | $77.62 | $112.20 |
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 $1,202.26 Typical High $2,187.76 | Professional | P3 · Severe systemic disease | $398.11 | $1,202.26 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $398.11 Median $1,258.93 Typical High $2,290.87 | Professional | P4 · Life-threatening disease | $398.11 | $1,258.93 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $398.11 Median $1,318.26 Typical High $2,398.83 | Professional | P5 · Not expected to survive without surgery | $398.11 | $1,318.26 | $2,398.83 |