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 $45.71 Median $45.71 Typical High $70.79 | Professional | None | $45.71 | $45.71 | $70.79 |
CareFirst Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | None | $58.88 | $58.88 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $89.13 | Facility | None | $85.11 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $169.82 | Professional | None | $79.43 | $112.20 | $169.82 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Facility | None | $72.44 | $72.44 | $75.86 |
United Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $87.10 | Professional | None | $50.12 | $54.95 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $95.50 | Professional | None | $66.07 | $67.61 | $95.50 |
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 $22.91 Median $22.91 Typical High $29.51 | Professional | 52 · Reduced service | $22.91 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $11.75 | Professional | 53 · Discontinued | $9.12 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $8.91 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.89 |
Where Maryland sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 46th of 51
$64.57
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.