How much rates vary
Facilitymedian $490 · 10th to 90th $490 to $490Professionalmedian $55 · 10th to 90th $3 to $389
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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $446.68 | Professional | None | $30.20 | $30.20 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $6.03 | Professional | None | $2.95 | $2.95 | $6.03 |
CareFirst Setting Professional Modifier NA Typical Low $3.09 Median $3.31 Typical High $3.47 | Professional | NA | $3.09 | $3.31 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $478.63 | Professional | None | $208.93 | $323.59 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $512.86 | Professional | None | $199.53 | $371.54 | $512.86 |
United Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $89.13 | Professional | None | $44.67 | $54.95 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $229.09 Median $436.52 Typical High $602.56 | Professional | P3 · Severe systemic disease | $229.09 | $436.52 | $602.56 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $263.03 Median $501.19 Typical High $676.08 | Professional | P4 · Life-threatening disease | $263.03 | $501.19 | $676.08 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $295.12 Median $562.34 Typical High $776.25 | Professional | P5 · Not expected to survive without surgery | $295.12 | $562.34 | $776.25 |