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 $61.66 Median $61.66 Typical High $69.18 | Professional | None | $61.66 | $61.66 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | None | $81.28 | $81.28 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $234.42 | Professional | None | $107.15 | $154.88 | $234.42 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Facility | None | $79.43 | $79.43 | $85.11 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $120.23 | Professional | None | $58.88 | $75.86 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $131.83 | Professional | None | $77.62 | $77.62 | $131.83 |
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 $30.90 Median $30.90 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $13.80 | Professional | 53 · Discontinued | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.92 |
Where Maryland sits
The same service costs 5.1 times more in Kansas 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· 39th of 51
$77.62
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.