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 $724.44 Median $724.44 Typical High $912.01 | Professional | None | $724.44 | $724.44 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,230.27 | Professional | None | $954.99 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,819.70 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Facility | None | $1,174.90 | $1,174.90 | $1,479.11 |
United Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,380.38 | Professional | None | $794.33 | $870.96 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,047.13 | $1,513.56 |
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 $363.08 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $91.20 |
Where Maryland sits
The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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· 45th of 51
$955
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.