How much rates vary
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 $575.44 | Facility | None | $38.02 | $40.74 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $40.74 Typical High $288.40 | Professional | None | $22.91 | $40.74 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $371.54 | Professional | None | $162.18 | $173.78 | $371.54 |
Blue Shield Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $218.78 | Professional | None | $128.82 | $181.97 | $218.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $81.28 | Professional | None | $20.42 | $25.12 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $302.00 | Professional | None | $138.04 | $190.55 | $302.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $125.89 | Professional | None | $61.66 | $91.20 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $436.52 | Professional | None | $117.49 | $177.83 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $954.99 Median $1,905.46 Typical High $1,905.46 | Professional | None | $954.99 | $1,905.46 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $295.12 | Professional | None | $125.89 | $190.55 | $295.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $89.13 | Professional | None | $38.02 | $50.12 | $89.13 |
4 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AA · Anesthesiologist Typical Low $208.93 Median $446.68 Typical High $1,071.52 | Professional | AA · Anesthesiologist | $208.93 | $446.68 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $89.13 Median $302.00 Typical High $549.54 | Professional | P3 · Severe systemic disease | $89.13 | $302.00 | $549.54 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $89.13 Median $363.08 Typical High $660.69 | Professional | P4 · Life-threatening disease | $89.13 | $363.08 | $660.69 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $89.13 Median $416.87 Typical High $758.58 | Professional | P5 · Not expected to survive without surgery | $89.13 | $416.87 | $758.58 |