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 $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $478.63 | Professional | None | $380.19 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,023.29 | Professional | None | $478.63 | $691.83 | $1,023.29 |
United Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $537.03 | Professional | None | $281.84 | $338.84 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $588.84 | Professional | None | $371.54 | $371.54 | $588.84 |
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 $138.04 Median $138.04 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $54.95 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $33.11 |
Where Maryland sits
The same service costs 2.5 times more in Iowa 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· 40th of 51
$372
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.