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 $47.86 Median $47.86 Typical High $53.70 | Professional | None | $47.86 | $47.86 | $53.70 |
CareFirst Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | None | $61.66 | $61.66 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $177.83 | Professional | None | $83.18 | $117.49 | $177.83 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Facility | None | $47.86 | $47.86 | $64.57 |
United Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $91.20 | Professional | None | $43.65 | $57.54 | $91.20 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $100.00 | Professional | None | $58.88 | $58.88 | $100.00 |
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 $23.99 Median $23.99 Typical High $26.30 | Professional | 52 · Reduced service | $23.99 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $10.72 | Professional | 53 · Discontinued | $9.55 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.94 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.25 |
Where Maryland sits
The same service costs 3.2 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· 40th of 51
$58.88
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.