How much rates vary
Facilitymedian $41 · 10th to 90th $38 to $724Professionalmedian $219 · 10th to 90th $41 to $1,202
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 $38.02 Median $40.74 Typical High $380.19 | Professional | None | $38.02 | $40.74 | $380.19 |
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 $20.42 Median $25.12 Typical High $109.65 | Professional | None | $20.42 | $25.12 | $109.65 |
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 $77.62 Median $114.82 Typical High $158.49 | Professional | None | $77.62 | $114.82 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $549.54 | Professional | None | $147.91 | $218.78 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,202.26 | $2,398.83 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $107.15 Median $363.08 Typical High $660.69 | Professional | P3 · Severe systemic disease | $107.15 | $363.08 | $660.69 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $107.15 Median $416.87 Typical High $758.58 | Professional | P4 · Life-threatening disease | $107.15 | $416.87 | $758.58 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $112.20 Median $478.63 Typical High $870.96 | Professional | P5 · Not expected to survive without surgery | $112.20 | $478.63 | $870.96 |