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 $338.84 Median $338.84 Typical High $524.81 | Professional | None | $338.84 | $338.84 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | None | $660.69 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,122.02 | Professional | None | $489.78 | $741.31 | $1,122.02 |
United Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $954.99 | Professional | None | $549.54 | $616.60 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $660.69 | Professional | None | $446.68 | $588.84 | $660.69 |
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 $169.82 Median $169.82 Typical High $234.42 | Professional | 52 · Reduced service | $169.82 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $93.33 | Professional | 53 · Discontinued | $67.61 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $46.77 |
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
$661
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.