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 $46.77 | Professional | None | $39.81 | $39.81 | $46.77 |
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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
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 $41.69 Median $41.69 Typical High $45.71 | Facility | None | $41.69 | $41.69 | $45.71 |
United Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $77.62 | Professional | None | $37.15 | $48.98 | $77.62 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $85.11 | Professional | None | $48.98 | $48.98 | $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 $23.44 | Professional | 52 · Reduced service | $19.95 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.33 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.68 |
Where Maryland sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 43rd of 51
$48.98
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.