How much rates vary
Facilitymedian $302 · 10th to 90th $234 to $437Professionalmedian $282 · 10th to 90th $52 to $407
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $263.03 Median $371.54 Typical High $436.52 | Facility | None | $263.03 | $371.54 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $478.63 | Professional | None | $40.74 | $52.48 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $346.74 | Professional | None | $204.17 | $239.88 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $436.52 | Professional | None | $309.03 | $363.08 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $478.63 | Facility | None | $263.03 | $371.54 | $478.63 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $263.03 Typical High $457.09 | Professional | None | $52.48 | $263.03 | $457.09 |
Pacific Source Setting Facility Modifier None Typical Low $234.42 Median $288.40 Typical High $380.19 | Facility | None | $234.42 | $288.40 | $380.19 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $5,128.61 Typical High $5,128.61 | Facility | None | $457.09 | $5,128.61 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $239.88 Typical High $354.81 | Professional | None | $70.79 | $239.88 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $389.05 | Professional | None | $288.40 | $302.00 | $389.05 |
9 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $8.13 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $371.54 Median $436.52 Typical High $512.86 | Professional | P3 · Severe systemic disease | $371.54 | $436.52 | $512.86 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $436.52 Median $501.19 Typical High $602.56 | Professional | P4 · Life-threatening disease | $436.52 | $501.19 | $602.56 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $501.19 Median $575.44 Typical High $691.83 | Professional | P5 · Not expected to survive without surgery | $501.19 | $575.44 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $9.55 | $10.72 | $10.72 |
Regence BlueShield Setting Professional Modifier AD · Supervising 5+ Typical Low $144.54 Median $151.36 Typical High $194.98 | Professional | AD · Supervising 5+ | $144.54 | $151.36 | $194.98 |
Regence BlueShield Setting Professional Modifier QK · Directing 2–4 cases Typical Low $144.54 Median $151.36 Typical High $194.98 | Professional | QK · Directing 2–4 cases | $144.54 | $151.36 | $194.98 |
Regence BlueShield Setting Professional Modifier QX · CRNA, directed Typical Low $144.54 Median $151.36 Typical High $194.98 | Professional | QX · CRNA, directed | $144.54 | $151.36 | $194.98 |
Regence BlueShield Setting Professional Modifier QY · Directing one CRNA Typical Low $144.54 Median $151.36 Typical High $194.98 | Professional | QY · Directing one CRNA | $144.54 | $151.36 | $194.98 |