How much rates vary
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 $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $676.08 | Professional | None | $30.20 | $30.20 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $2.95 Median $3.31 Typical High $3.31 | Professional | None | $2.95 | $3.31 | $3.31 |
CareFirst Setting Professional Modifier NA Typical Low $3.02 Median $3.16 Typical High $5.01 | Professional | NA | $3.02 | $3.16 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $776.25 | Professional | None | $338.84 | $524.81 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $776.25 | Professional | None | $295.12 | $562.34 | $776.25 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $331.13 Median $616.60 Typical High $851.14 | Professional | P3 · Severe systemic disease | $331.13 | $616.60 | $851.14 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $363.08 Median $676.08 Typical High $933.25 | Professional | P4 · Life-threatening disease | $363.08 | $676.08 | $933.25 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $398.11 Median $741.31 Typical High $1,023.29 | Professional | P5 · Not expected to survive without surgery | $398.11 | $741.31 | $1,023.29 |