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 $30.90 Median $30.90 Typical High $36.31 | Professional | None | $30.90 | $30.90 | $36.31 |
CareFirst Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $53.70 | Professional | None | $40.74 | $40.74 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $117.49 | Professional | None | $54.95 | $77.62 | $117.49 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $60.26 | Professional | None | $30.90 | $38.02 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $66.07 | Professional | None | $40.74 | $40.74 | $66.07 |
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 $15.49 Median $15.49 Typical High $18.20 | Professional | 52 · Reduced service | $15.49 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.37 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.63 |
Where Maryland sits
The same service costs 2.9 times more in Hawaii than in Delaware. 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· 31st of 51
$40.74
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.