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 $74.13 Median $74.13 Typical High $91.20 | Professional | None | $74.13 | $74.13 | $91.20 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | None | $97.72 | $97.72 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $275.42 | Professional | None | $128.82 | $186.21 | $275.42 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $144.54 | Professional | None | $67.61 | $91.20 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $158.49 | Professional | None | $91.20 | $91.20 | $158.49 |
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 $37.15 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $37.15 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $14.79 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $8.32 |
Where Maryland sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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
$91.20
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.