How much rates vary
Facilitymedian $41 · 10th to 90th $38 to $871Professionalmedian $263 · 10th to 90th $41 to $1,445
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 $870.96 | Facility | None | $38.02 | $40.74 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $457.09 | Professional | None | $38.02 | $40.74 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $549.54 | Professional | None | $239.88 | $263.03 | $549.54 |
Blue Shield Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $331.13 | Professional | None | $190.55 | $275.42 | $331.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $134.90 | Professional | None | $20.42 | $25.12 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $501.19 | Professional | None | $229.09 | $323.59 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $186.21 | Professional | None | $93.33 | $138.04 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $660.69 | Professional | None | $177.83 | $263.03 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $2,884.03 | Professional | None | $1,445.44 | $2,884.03 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $467.74 | Professional | None | $208.93 | $323.59 | $467.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $89.13 | Professional | None | $38.02 | $50.12 | $89.13 |
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 $125.89 Median $416.87 Typical High $758.58 | Professional | P3 · Severe systemic disease | $125.89 | $416.87 | $758.58 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $125.89 Median $478.63 Typical High $870.96 | Professional | P4 · Life-threatening disease | $125.89 | $478.63 | $870.96 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $134.90 Median $537.03 Typical High $977.24 | Professional | P5 · Not expected to survive without surgery | $134.90 | $537.03 | $977.24 |