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 $12.88 Median $12.88 Typical High $20.42 | Professional | None | $12.88 | $12.88 | $20.42 |
CareFirst Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | None | $16.98 | $16.98 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $31.62 | Facility | None | $22.39 | $22.39 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $47.86 | Professional | None | $22.39 | $32.36 | $47.86 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Facility | None | $19.95 | $19.95 | $28.18 |
United Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $25.12 | Professional | None | $13.49 | $15.85 | $25.12 |
Wellpoint Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $27.54 | Professional | None | $17.78 | $20.89 | $27.54 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $6.46 Typical High $7.76 | Professional | 52 · Reduced service | $6.46 | $6.46 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $3.09 | Professional | 53 · Discontinued | $2.57 | $2.57 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.34 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.55 |
Where Maryland sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 41st of 51
$16.98
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.