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 $380.19 Median $380.19 Typical High $676.08 | Professional | None | $380.19 | $380.19 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $812.83 | Professional | None | $588.84 | $588.84 | $812.83 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,258.93 | Professional | None | $562.34 | $851.14 | $1,258.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,000.00 | Professional | None | $588.84 | $645.65 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $691.83 Typical High $758.58 | Professional | None | $162.18 | $691.83 | $758.58 |
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 $186.21 Median $186.21 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | 53 · Discontinued | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $83.18 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $54.95 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | RR · Rental | $69.18 | $69.18 | $81.28 |
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· 35th of 51
$724
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.