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 $120.23 Median $120.23 Typical High $144.54 | Professional | None | $120.23 | $120.23 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $204.17 | Professional | None | $158.49 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $446.68 | Professional | None | $208.93 | $302.00 | $446.68 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $194.98 | Facility | None | $190.55 | $190.55 | $194.98 |
United Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $234.42 | Professional | None | $131.83 | $147.91 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $257.04 | Professional | None | $177.83 | $177.83 | $257.04 |
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 $60.26 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $60.26 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $29.51 | Professional | 53 · Discontinued | $23.99 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.45 |
Where Maryland sits
The same service costs 3.5 times more in Hawaii 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· 44th of 51
$158
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.