How much rates vary
Facilitymedian $41 · 10th to 90th $38 to $724Professionalmedian $224 · 10th to 90th $41 to $891
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 $724.44 | Facility | None | $38.02 | $40.74 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $40.74 Typical High $354.81 | Professional | None | $22.91 | $40.74 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $467.74 | Professional | None | $199.53 | $218.78 | $467.74 |
Blue Shield Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $275.42 | Professional | None | $162.18 | $229.09 | $275.42 |
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 $181.97 Median $257.04 Typical High $398.11 | Professional | None | $181.97 | $257.04 | $398.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $134.90 | Professional | None | $67.61 | $100.00 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $436.52 | Professional | None | $123.03 | $251.19 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $2,398.83 Typical High $2,398.83 | Professional | None | $891.25 | $2,398.83 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $389.05 | Professional | None | $169.82 | $257.04 | $389.05 |
Sutter Health Plus Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $112.20 | Professional | None | $52.48 | $77.62 | $112.20 |
6 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 $7.59 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $7.59 | $8.13 | $8.13 |
Ambetter Setting Professional Modifier AA · Anesthesiologist Typical Low $354.81 Median $478.63 Typical High $549.54 | Professional | AA · Anesthesiologist | $354.81 | $478.63 | $549.54 |
Ambetter Setting Professional Modifier QZ · CRNA, independent Typical Low $234.42 Median $275.42 Typical High $416.87 | Professional | QZ · CRNA, independent | $234.42 | $275.42 | $416.87 |
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $89.13 Median $363.08 Typical High $660.69 | Professional | P3 · Severe systemic disease | $89.13 | $363.08 | $660.69 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $89.13 Median $416.87 Typical High $758.58 | Professional | P4 · Life-threatening disease | $89.13 | $416.87 | $758.58 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $89.13 Median $478.63 Typical High $870.96 | Professional | P5 · Not expected to survive without surgery | $89.13 | $478.63 | $870.96 |