How much rates vary
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 $208.93 Median $302.00 Typical High $354.81 | Facility | None | $208.93 | $302.00 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $380.19 | Professional | None | $38.02 | $52.48 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $275.42 | Professional | None | $151.36 | $181.97 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $346.74 | Professional | None | $245.47 | $288.40 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $302.00 Typical High $389.05 | Facility | None | $208.93 | $302.00 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $199.53 Typical High $363.08 | Professional | None | $52.48 | $199.53 | $363.08 |
Pacific Source Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $302.00 | Facility | None | $186.21 | $208.93 | $302.00 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $5,128.61 Typical High $5,128.61 | Facility | None | $363.08 | $5,128.61 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $181.97 Typical High $281.84 | Professional | None | $70.79 | $181.97 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $309.03 | Professional | None | $229.09 | $239.88 | $309.03 |
United Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $87.10 | Professional | None | $51.29 | $64.57 | $87.10 |
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 |
|---|---|---|---|---|---|
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $309.03 Median $363.08 Typical High $436.52 | Professional | P3 · Severe systemic disease | $309.03 | $363.08 | $436.52 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $371.54 Median $436.52 Typical High $512.86 | Professional | P4 · Life-threatening disease | $371.54 | $436.52 | $512.86 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $436.52 Median $501.19 Typical High $602.56 | Professional | P5 · Not expected to survive without surgery | $436.52 | $501.19 | $602.56 |
Moda Health Setting Professional Modifier P2 · Mild systemic disease Typical Low $97.72 Median $117.49 Typical High $251.19 | Professional | P2 · Mild systemic disease | $97.72 | $117.49 | $251.19 |
Moda Health Setting Professional Modifier P3 · Severe systemic disease Typical Low $114.82 Median $125.89 Typical High $190.55 | Professional | P3 · Severe systemic disease | $114.82 | $125.89 | $190.55 |
Regence BlueShield Setting Professional Modifier AD · Supervising 5+ Typical Low $114.82 Median $120.23 Typical High $154.88 | Professional | AD · Supervising 5+ | $114.82 | $120.23 | $154.88 |
Regence BlueShield Setting Professional Modifier QK · Directing 2–4 cases Typical Low $114.82 Median $120.23 Typical High $154.88 | Professional | QK · Directing 2–4 cases | $114.82 | $120.23 | $154.88 |
Regence BlueShield Setting Professional Modifier QX · CRNA, directed Typical Low $114.82 Median $120.23 Typical High $154.88 | Professional | QX · CRNA, directed | $114.82 | $120.23 | $154.88 |
Regence BlueShield Setting Professional Modifier QY · Directing one CRNA Typical Low $114.82 Median $120.23 Typical High $154.88 | Professional | QY · Directing one CRNA | $114.82 | $120.23 | $154.88 |