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 $38.02 Median $38.02 Typical High $47.86 | Professional | None | $38.02 | $38.02 | $47.86 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Professional | None | $50.12 | $50.12 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $144.54 | Professional | None | $67.61 | $95.50 | $144.54 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Facility | None | $47.86 | $47.86 | $58.88 |
United Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $74.13 | Professional | None | $39.81 | $46.77 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $81.28 | Professional | None | $52.48 | $52.48 | $81.28 |
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 $19.05 Median $19.05 Typical High $23.99 | Professional | 52 · Reduced service | $19.05 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $9.55 | Professional | 53 · Discontinued | $7.76 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $7.08 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.79 |
Where Maryland sits
The same service costs 3.4 times more in Hawaii than in Vermont. 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· 43rd of 51
$50.12
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.