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 $295.12 Median $295.12 Typical High $354.81 | Professional | None | $295.12 | $295.12 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $501.19 | Professional | None | $389.05 | $389.05 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,096.48 | Professional | None | $512.86 | $741.31 | $1,096.48 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Facility | None | $295.12 | $295.12 | $331.13 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $575.44 | Professional | None | $288.40 | $363.08 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $630.96 | Professional | None | $380.19 | $380.19 | $630.96 |
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 $147.91 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $35.48 |
Where Maryland sits
The same service costs 3.0 times more in Montana 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· 35th of 51
$380
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.