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 $117.49 Median $117.49 Typical High $147.91 | Professional | None | $117.49 | $117.49 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | None | $154.88 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $436.52 | Professional | None | $204.17 | $295.12 | $436.52 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Facility | None | $190.55 | $190.55 | $208.93 |
United Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $229.09 | Professional | None | $128.82 | $144.54 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Professional | None | $173.78 | $173.78 | $251.19 |
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 $58.88 Median $58.88 Typical High $74.13 | Professional | 52 · Reduced service | $58.88 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $29.51 | Professional | 53 · Discontinued | $23.44 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $14.79 |
Where Maryland sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 49th of 51
$162
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.