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 $134.90 Median $134.90 Typical High $229.09 | Professional | None | $134.90 | $134.90 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | None | $263.03 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $446.68 | Professional | None | $194.98 | $295.12 | $446.68 |
United Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $380.19 | Professional | None | $218.78 | $245.47 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $269.15 | Professional | None | $151.36 | $151.36 | $269.15 |
5 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 $67.61 Median $67.61 Typical High $93.33 | Professional | 52 · Reduced service | $67.61 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $26.92 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $18.62 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Where Maryland sits
The same service costs 2.6 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
$263
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.