How much rates vary
Facilitymedian $417 · 10th to 90th $45 to $3,388Professionalmedian $257 · 10th to 90th $47 to $490
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 $380.19 Typical High $537.03 | Facility | None | $44.67 | $380.19 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $478.63 | Professional | None | $44.67 | $56.23 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $512.86 | Professional | None | $151.36 | $257.04 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $489.78 | Professional | None | $257.04 | $338.84 | $489.78 |
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 $302.00 Median $398.11 Typical High $575.44 | Professional | None | $302.00 | $398.11 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $575.44 | Professional | None | $331.13 | $416.87 | $575.44 |
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 $346.74 Median $467.74 Typical High $660.69 | Professional | P3 · Severe systemic disease | $346.74 | $467.74 | $660.69 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $398.11 Median $537.03 Typical High $758.58 | Professional | P4 · Life-threatening disease | $398.11 | $537.03 | $758.58 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $446.68 Median $602.56 Typical High $851.14 | Professional | P5 · Not expected to survive without surgery | $446.68 | $602.56 | $851.14 |