How much rates vary
Facilitymedian $41 · 10th to 90th $38 to $575Professionalmedian $141 · 10th to 90th $41 to $955
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 $26.92 Median $41.69 Typical High $309.03 | Professional | None | $26.92 | $41.69 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $426.58 | Professional | None | $134.90 | $134.90 | $426.58 |
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 $28.18 | Professional | None | $20.42 | $25.12 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $457.09 | Professional | None | $138.04 | $194.98 | $457.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $95.50 | Professional | None | $57.54 | $69.18 | $95.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $457.09 | Professional | None | $93.33 | $177.83 | $457.09 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $338.84 | Professional | None | $125.89 | $190.55 | $338.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | AA · Anesthesiologist | $724.44 | $724.44 | $724.44 |
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $67.61 Median $302.00 Typical High $575.44 | Professional | P3 · Severe systemic disease | $67.61 | $302.00 | $575.44 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $67.61 Median $363.08 Typical High $691.83 | Professional | P4 · Life-threatening disease | $67.61 | $363.08 | $691.83 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $67.61 Median $416.87 Typical High $794.33 | Professional | P5 · Not expected to survive without surgery | $67.61 | $416.87 | $794.33 |