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 $39.81 Median $39.81 Typical High $47.86 | Professional | None | $39.81 | $39.81 | $47.86 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $67.61 | Professional | None | $52.48 | $52.48 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $147.91 | Professional | None | $69.18 | $100.00 | $147.91 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Facility | None | $56.23 | $56.23 | $58.88 |
United Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $77.62 | Professional | None | $39.81 | $48.98 | $77.62 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $85.11 | Professional | None | $52.48 | $52.48 | $85.11 |
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 $19.95 Median $19.95 Typical High $23.99 | Professional | 52 · Reduced service | $19.95 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.55 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.24 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.79 |
Where Maryland sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 42nd of 51
$52.48
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.