How much rates vary
Facilitymedian $282 · 10th to 90th $45 to $3,388Professionalmedian $170 · 10th to 90th $47 to $324
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 $257.04 Typical High $354.81 | Facility | None | $44.67 | $257.04 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $323.59 | Professional | None | $44.67 | $56.23 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $338.84 | Professional | None | $102.33 | $173.78 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $288.40 | Professional | None | $151.36 | $199.53 | $288.40 |
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 $199.53 Median $269.15 Typical High $380.19 | Professional | None | $199.53 | $269.15 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $380.19 | Professional | None | $218.78 | $281.84 | $380.19 |
United Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $95.50 | Professional | None | $39.81 | $66.07 | $95.50 |
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 $251.19 Median $338.84 Typical High $478.63 | Professional | P3 · Severe systemic disease | $251.19 | $338.84 | $478.63 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $302.00 Median $398.11 Typical High $575.44 | Professional | P4 · Life-threatening disease | $302.00 | $398.11 | $575.44 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $346.74 Median $467.74 Typical High $660.69 | Professional | P5 · Not expected to survive without surgery | $346.74 | $467.74 | $660.69 |