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 $70.79 Median $70.79 Typical High $120.23 | Professional | None | $70.79 | $70.79 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $120.23 | Professional | None | $91.20 | $91.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $97.72 | Facility | None | $95.50 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $263.03 | Professional | None | $123.03 | $173.78 | $263.03 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Facility | None | $79.43 | $79.43 | $89.13 |
United Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $134.90 | Professional | None | $66.07 | $85.11 | $134.90 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $147.91 | Professional | None | $75.86 | $87.10 | $147.91 |
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 $35.48 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $35.48 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $14.13 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.76 |
Where Maryland sits
The same service costs 2.8 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· 45th of 51
$87.10
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.