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 $239.88 Median $239.88 Typical High $288.40 | Professional | None | $239.88 | $239.88 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | None | $309.03 | $309.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $616.60 | Facility | None | $380.19 | $380.19 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $891.25 | Professional | None | $416.87 | $588.84 | $891.25 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Facility | None | $389.05 | $389.05 | $467.74 |
United Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $457.09 | Professional | None | $263.03 | $288.40 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $501.19 | Professional | None | $346.74 | $346.74 | $501.19 |
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 $120.23 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $47.86 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $28.84 |
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· 44th of 51
$309
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.