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 Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $36.31 | Professional | None | $26.30 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $16.98 Typical High $18.20 | Professional | 52 · Reduced service | $13.18 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.92 Typical High $7.24 | Professional | 53 · Discontinued | $5.25 | $6.92 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.13 Typical High $5.50 | Professional | 55 · Aftercare only | $3.98 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.63 | $3.39 | $3.63 |
CareFirst Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | None | $36.31 | $36.31 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $83.18 | Professional | None | $38.90 | $54.95 | $83.18 |
United Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $43.65 | Professional | None | $24.55 | $26.92 | $43.65 |
Wellpoint Setting Professional Modifier None Typical Low $33.11 Median $46.77 Typical High $46.77 | Professional | None | $33.11 | $46.77 | $46.77 |
1 more rate 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 |
|---|---|---|---|---|---|
Wellpoint Setting Professional Modifier KX · Policy requirements met Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | KX · Policy requirements met | $26.92 | $26.92 | $26.92 |
Where Maryland sits
The same service costs 2.2 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 27th of 51
$36.31
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.