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 $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | None | $707.95 | $707.95 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,041.74 | Professional | None | $954.99 | $1,380.38 | $2,041.74 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,047.13 | Professional | None | $537.03 | $676.08 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,174.90 | Professional | None | $446.68 | $758.58 | $1,174.90 |
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 $275.42 Median $275.42 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $66.07 |
Where Maryland sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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
$708
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.